I grew up believing in the advanced path of science and medicine progress – that human health would continue to improve as it was for hundreds of years. As I progressed through my career in medical science, I was still optimistic.
Now I have serious doubts.
Science continues to function well, but lethal obstacles block the path between research and progress in the field on which I work: Antibiotics.
The threat to humanity is serious and it's still worse day, but for the reasons that my colleagues and myself are avoiding, there seems to be a shockingly small collective will to do a lot.
This week (November 12th and 18th) is the week of global antibiotic awareness. We need to talk about this threat. We need to develop models of public-private cooperation – to stimulate, finance and invest in the detection and development of antibiotics.
Penicillin has led to complacency
Here's the problem: about 75 years ago, science brought penicillin into public use, opening a new era in the control of infectious diseases, just as it did remediation before. Infectious diseases such as lungs and strep, which were usually fatal even after my grandmother and grandmother's day, have been tampered with – at least for some time.
In the subsequent generations, the expected lifespan jumped 25 years, and the infectious disease fell from number one to one place among all causes of death of people, where he consistently ranked more than bullets and bombs – even during world wars.
With a cheap, richer and more efficient antibiotic, people in the developed world have become satisfied with controlling the infection.
But this whole time, while we lived in better, longer lives, contagious diseases work on return, and today they are sent to the door. In fact, they are already breaking the door.
The market will not meet demand
In a quick example of Darwinian adaptation through natural selection, bacteria and other microbes are developed to survive antibiotics. They will continue to adapt and they will succeed unless a person builds new layers of defense in the form of new antibiotics and other creative approaches.
The governments of the world recognize the crisis, as confirmed at a special meeting of the United Nations General Assembly at the high level in 2016 and the G20 in 2017.
The disturbing part is that we know what we need to do to create new antibiotic therapies, although the job is undoubtedly difficult, there are already some promising new alternatives to older drugs, and more are in progress.
Unfortunately, they are still not available in the commercial market and they will never arrive there until something changes to make them sustainable – not as drugs, but as slaves.
A criminal barrier to the production of new antibiotics is our own economic model, which believes the market to meet demand. The invisible hand, as the philosopher and economist Adam Smith called it, is not working here, and what is at stake is the progress made by antibiotics.
Canada could lead a struggle for life in the post-antibiotic world
The public model is risky
Last year in the United States, two pharmaceutical companies approved FDA approval for new antibiotic compounds. As soon as markets learned that these companies had created drugs that would literally save the world, their actions fell.
It sounds counter-intuitive, is not it? It turns out that the consumption of hundreds of millions for the creation, testing, and placement of a new drug is a bad risk, unless the drug can return the investment within 20 years before the end of its patent.
It's hard to do when you're trying to get the cost of a 10-day recipe at the same time. And when you prescribe a new drug only for infections that can not be solved by cheap, traditional antibiotics, which still work in many cases.
The only way to create a sense of creating new antibiotics is to astronomically expensive them, in the scope of rare drugs for cancer and who would pay for it?
Many claim that we should look at antibiotics in the same way we look at firefighters. As individuals, we may never need them, but we are all willing to share the costs, because we expect them to be there.
The public model seems to make sense, but who will take political risk?
Hospitals under threat
No intervention – when the public through its governments around the world cooperates with the private sector to help stimulate, finance and invest in the detection and development of antibiotics, the end of effective antibiotics will be daunting.
This will happen gradually, but it will certainly be. The first stages are already here in the form of infections resistant to multi-antibiotics, which endanger the basic function of hospitals.
We will then see common procedures, such as dental hygiene settings and joint replacement operations, permanently canceled due to the risk of infection.
People of all age groups are starting to die again of the diseases that we have become accustomed to treating a tablet of 10 or 20 dollars. Those who do not die will be more frequent and much longer, encouraging care costs.
The expected life expectancy could be returned where it was in the early 1900s, and the golden age of antibiotics would prove to be a short, happy blip in history.
It does not have to be this way. Let's turn consciousness into action.