This article was originally published in the journal Saruna, an independent and non-profit source of news, analysis and commentary from academic experts. Disclosure is available on the original website.
By: Gerry Wright, Professor of Biochemistry and Biomedicine, McMaster University
I grew up believing in the direction of progress in science and medicine – human health will continue to improve, as was the case for hundreds of years. When I continued my career in health sciences, I continued to be optimistic.
Now I have serious doubts.
Science is still working well, but deadly barriers block the path between research and progress in the area where I work: antibiotics.
Menace threats have been serious and have continued to worsen to the day, but for the reasons that avert my colleagues and me, it seems that shockingly little collective will do so.
This week (12-18 November) is the World Antibiotics Awareness Week. We have to talk about these threats. We need to develop public-private partnership models – to stimulate, finance and invest in the detection and development of antibiotics.
Penicillin caused complacency
This is a problem: about 75 years ago, science attracted penicillin to the public, opening up a new era for the control of communicable diseases, because sanitation was done before. Infectious diseases such as pneumonia and strep, which were often deaths even at the time of my grandparents, were frustrating – at least temporarily.
In subsequent generations, life expectancy increased by 25 years, and infectious disease from its first place fell by one place among all causes of death, where it was always higher than bullets and bombs – even during the World Wars.
With the presence of cheap, rich and effective antibiotics, people in the developed world became more comfortable with infection control.
But all this time, while we have lived better, longer lives, infectious diseases have been working on the return, and today they are shaking at the door. In fact, they have already split the door.
The market will not meet the demand
In Darwin customization preview, using natural selection, bacteria and other microbes evolve to survive antibiotics. They will continue to adapt and will only succeed if humanity sets new levels of protection in the form of new antibiotics and other creative approaches.
The world governments recognize the crisis, as confirmed by the UN General Assembly Special Summit in 2016 and the G20 in 2017.
The problem is that we know what we need to do to create new antibiotic therapies, and although work is undoubtedly tough, there are already some promising new alternative solutions for older drugs and more are being prepared.
Unfortunately, they are not yet available on the commercial market, and they can never get if something changes to make it viable – not as a drug, but as a commodity.
The critical barrier to the production of new antibiotics proves to be our own economic model, which trusts the market to meet demand. The invisible hand, as a philosopher and economist Adams Smith called it, does not work here, and everything that is in danger is all the progress that antibiotics have made possible.
The public model is risky
Last summer, two pharmaceutical companies in the United States obtained FDA approval for new antibiotic compounds. As markets discovered that these companies have created drugs that can literally save the world, their stocks have fallen.
Sounds intuitive or not? It turns out that spending hundreds of millions to create, test and sell a new drug is a bad risk unless the medicine can not recover the investment within 20 years before the patent expires.
It's hard to do if you try to reimburse one 10-day recipe once. And when you make the new medicine only for infections that can not be solved with cheap, traditional antibiotics that still work in many cases.
The only way it could make the business sense to create new antibiotics would be to make them astronomically expensive in the range of rare cancers and who would pay for it?
Many argue that we should look at antibiotics in the same way that we look at fire brigades. As individuals, we can never need them, but we are all ready to share costs, because we expect them to be there.
The public model seems to make sense, but who will take on political risk?
Hospitals are at risk
Without interference – if the public, through its governments around the world, is working with the private sector to help stimulate, finance and invest in antibiotic detection and development, the end of effective antibiotics will be intimidating.
It will happen gradually, but it will definitely happen. The first stages are already here in the form of many antibiotic-resistant infections that endanger the basic function of hospitals.
Below we will see the usual procedures, such as dental hygiene and joint replacement surgery, which were permanently eliminated due to the risk of infection.
People of all ages will begin to die again from the diseases we have used to treat 10 to 20 dollar pills. Those who do not die will get sick more often and much longer, increasing the cost of care.
Life expectancy could fall to where it was in the early 1900s, and the golden age of antibiotics might have been just a brief, happy insight into history.
It does not have to be this way. Let's turn our understanding into action.
This article has been republished from the Creative Commons License. Disclosure is available on the original website. Read the original article:
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