Despite desperate warnings and distressing premonitions about an apocalyptic society rife with indestructible bacteria plaguing the news, it’s a matter which very few of us pay any attention to.
Buzzfeed reports that fireworks claim fourteen times as many lives as terrorism; we have a 1/14,000,000 chance of dying in a plane crash, and even Ebola is far from being the deadliest disease in Africa, with malaria annually killing three times as many victims. In comparison, antibiotic resistance is a far more pressing risk. The online journal Alphr testified that multi-drug resistance bacteria can be held accountable for 25,000 deaths in Europe every year, as well as almost 400,000 infections. It is a problem that, quite frankly, could be the death of us all.
Recently The Guardian reported how one doctor describes antibiotic resistance as the most eloquent example of Darwin’s principle of evolution that there ever was. Just as species evolve and adapt to their surroundings, bacteria does the same. As they become familiar with the drugs trying to eliminate them, they adjust their defensive mechanisms to such an extent that they become resistant. And this is happening at an alarmingly quick rate. In 2013, the World Health Organisation (WHO) stated there had been 480,000 new cases of multi-drug resistant tuberculosis alone, with high proportions of resistance in bacteria causing common infections like pneumonia.
“Just as species evolve and adapt to their surroundings, bacteria does the same. As they become familiar with the drugs trying to eliminate them, they adjust their defensive mechanisms to such an extent that they become resistant”
A massive part of the reason for the development of antibiotic resistance lies within the meat industry, where antibiotics are routinely misused. The Natural Resources Defence Council (NRDC) claims that 80% of all antibiotics sold are used on livestock and poultry – not humans – and not only when animals are ill: instead, they are used daily, mixed with food and water, to make chickens, pigs and cows grow faster. This extensive use of antibiotics means bacteria are exposed to these drugs over a long period of time, facilitating their survival, multiplication and increased resistance. This resistant bacteria is subsequently transmitted to humans through meat consumption or direct contact, contributing significantly to the inefficacy of antibiotics.
The development of new antibiotics is also an area of concern; according to Alphr, every single strain in use today was developed over 29 years ago, meaning there is an extremely narrow field to pick from when resistance becomes a problem. The trouble is that antibiotics are shockingly expensive to develop – Forbes recently estimated the cost of developing just one new drug at $5billion – and because they are not massively profitable, many pharmaceutical companies are somewhat reluctant to invest in their production.
“Department of Health reported that almost 50% of antibiotic prescriptions are unnecessary, and carelessly given to patients suffering from viruses”
More optimistically, the development of resistance can also be significantly attributed to our own usage of antibiotics, which is therefore something we can alter. For example, an EU initiative supported by the Department of Health reported that almost 50% of antibiotic prescriptions are unnecessary, and carelessly given to patients suffering from viruses, upon which the effect of antibiotics is nil. Furthermore, some patients do not finish a course of antibiotics, allowing the particularly resistant bacteria still left in the body to reproduce and further increase their resilience.
The outlook for a world without antibiotics is bleak. What’s worse, is that the danger is greatest in hospitals where the vulnerability of the patient is already extensive. Organ transplants will be essentially impossible due to the need to suppress the immune system to prevent rejection, rendering the patient increasingly susceptible to infection. Similarly, treating a cancer patient with chemotherapy would be like administrating the lethal injection: fatal. And childbirth? Just a century ago, more than 600 women died per 100,000 births, starkly comparable to today’s figure of just 15. But this dramatic reduction in mortality can be attributed, in part, to the development of antibiotics, so in an era where these are no longer effective, we might just see this number tragically start to rise.
The medically miraculous discovery of penicillin in 1928 had sparked the transformation of a world where minor infections led to major mortalities into one where a simple dose could extend a human lifespan by decades. Now, in 2015, we are in a race with evolution and with bacteria, one of the fastest reproducing organisms in the world. It is naïve to think that we can win. We are on the cusp of inhabiting a post-antibiotic era, where a paper cut can kill.
Image: CDC Global