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'Without Action on Antibiotics, Medicine Will Return To the Dark Ages' (theguardian.com)
Four years ago professor Sally Davies, England's chief medical officer, gave the world a sombre warning of the growing threat posed by bacteria evolving resistance to life-saving antibiotics. If this were left unaddressed, she argued, it would lead to the erosion of modern medicine as we know it. Doctors and scientists had long warned of the problem, but few outside medicine were taking real heed. Consumption of antibiotics rose 36% between 2000 and 2010, writes Ed Whiting, director of policy and chief of staff at Wellcome, a biomedical research charity based in London. He notes that much of the progress in the field is yet to be made: We urgently need new antibiotics. No new classes of antibiotics have been approved since the early 1980s. Between 1940 and 1962 about 20 classes were produced, but industry backing has decreased significantly since that golden age. The pipeline of new treatments is all but dry, the void fast exploited by resistant bacteria. A concerning number are now resistant to drugs reserved as the last line of defence, and the most vulnerable are in greatest danger -- the young, old and critically ill. Blood infections caused by drug-resistant microbes kill more than 200,000 newborn babies each year. The reason for the lack of interest from the pharmaceutical industry is simple: the economics don't add up. Developing new antibiotics is scientifically challenging, time-consuming and costly. The medicines we so badly need cannot be allowed to be sold in volume; they must be conserved for real need, with fair access guaranteed. This limits their retail value. Many early-stage projects will fail, making them a risky bet. Even those that are successful will take at least a decade to produce medicines that are safe for human use.
help the POTUS to understand this!!!!
My dad has an infection in his arm which is only being moderately helped by intravenous Cipro and Vancomycin. They've sent a culture to Mayo to see if they can find a better treatment option but at this point I'm more than a little concerned. This stuff is already happening. They really need to get their heads out of the sand.
Oh... you mean markets cannot solve every problem on the planet?
Maybe if we spent a bunch of government grant money on the problem we could make it better?
Naw... the market always works... right? It's not like penicillin was discovered at St Mary's Hospital using government money.
Wait.... It was.
Another consultant who stuck it out.
"We are the Priests, of the Temples of Syrinx..."
... you don't (solely) rely on commercial companies to do your medical research for you.
It's why you fund academia to do the research and why government agencies do have a place in medicine. That model fits this problem much better than simple commerce.
We still know about germ theory, so we would still be sterilizing scalpels and tongs with heat or alcohol or whatever. And we have xray machines and anesthesia and all that other good stuff, so it's still gonna be way better than medicine in the dark ages.
Making new stronger antibiotics is only a temporary solution, bacteria will probably develop resistance to that too.
What's probably gonna happen is that surgery will become risky and very expensive. Everything in the surgery room will need to be sterilized extremely thoroughly, and you would need super air filtration systems like a CPU manufacturing clean room. Even then risk of infection will always be there. So you would only want surgery in life-threatening situations. No more nose job or tummy tuck or a hip replacement. If you have a bum hip, you're gonna be walking around on a cane or in a wheelchair like our ancestors did.
new antibiotics aren't going to be profitable. For one thing the drug companies make plenty on the existing ones. For another they're too essential for life, so they're prone to price controls. We could make them profitable enough but only by allowing business practices similar to what Epipen's Pharma Bro did.
This is what "Austerity" and rampant non-stop tax cuts gets you. This is something the government needs to step in and do. The days of one bright guy with a petri dish making a major breakthrough are gone. It takes hundreds of years for that guy to get lucky and strike gold. In the meantime we've got millions dying. Said it before, say it again: For anything more important than a twinkie you need an organized response, i.e. the government.
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There's a point to be made here. The dark ages bit is hyperbole, the vast majority of what goes into you being healthy is prevention, sanitation, gloves, and not throwing your feces into the street.
A lot of people these days seem okay with returning to the dark ages in terms of science and learning vs religion anyway. And they don't seem very sympathetic to sick people either. Maybe instead remind them that before antibiotics, soldiers died of infections nearly as often as they did of battle. Right wingers still care about soldiers right? At least in terms of their health BEFORE they fight?
fun fact: many of these antibiotics are developed through public private partnership with your local schools and universities under nondisclosure agreements which prevent any of the research from being made public. these NDAs often have expiration dates as far far as 80 years into the future.
the fact remains that if and when the cloistered elite need access to lifesaving medicine en-masse, these drugs will be quickly made available. If the cure for Hepatitis C was any indication, you'll certainly gain access to these advanced new antibiotics as well...at $30,000 a bottle.
Good people go to bed earlier.
True, medicine would only be returned to about its state in 1910, or perhaps 1900. Operations, even minor ones, would be a bad gamble with death...even when the best choice. Anesthetics would continue to be known and effective, but any incision could be fatal. Perhaps UV could substitute for some antibiotic uses, and strong poisons could be used to swab down surfaces, and disposable gloves and clothing could minimize risk. And... But we're already doing most of those things, and bacteria still get through.
I think we've pushed this "anyone can grow up to be president" thing too far.
If a college receives any public funds, than any research should be owned by the public. Any derivatives as well. Therefore, and/all penicillin based antibiotics should be profit-and-prescription free.
There's a point to be made here. The dark ages bit is hyperbole, the vast majority of what goes into you being healthy is prevention, sanitation, gloves, and not throwing your feces into the street.
Agreed! Having feces-free streets helps all of us, even those who don't need antibiotics. I think it's called turd-immunity.
Slow down, cowboy! It has been 4 hours since you last posted. You must wait another few hours.
OTOH, I'm not sure that new antibiotics are the solution. Managed bacterial ecology might be a better approach. This would include applying predatory bacterial strains selected for effectiveness against the infecting bacteria, and would also include disrupting bacterial culture communication networks. Etc. It might also include quite specific antibiotics that were effective against only one particular strain of bacteria...but those would be expensive to develop, you'd need a lot of them, and it would require quite precise determination of the causative agent. Tricky, but perhaps doable.
I think we've pushed this "anyone can grow up to be president" thing too far.
The worst part is, if a new antibiotics is discovered, it might help you right now, but after a couple of year, because of over use(*), the bacteria will eventually evolve some resistance against it. So the next patient with the same kind of infection will be again in the same situation...
Maybe time to dust off alternative therapies, like phage therapy ? (**)
Cue in citation of your favorite strategist (Churchill, Sun-Tzu, Machiavelli, etc.) commenting about the millennia-old proverb that the enemy of your enemy is your friend.
---
(*) : over-prescription, industrial/agricultural use, etc.
(**) : phage are like viruses but specialize in infecting bacteria. So phage therapy is basically curing your sickness, by making your sickness itself sick, with its own sickness, in a kind of pathogen-ception.
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
Whenever I read a statistic like Consumption of antibiotics rose 36% between 2000 and 2010 I wonder what they had to do to boil it all down to one number. For all I know this is accounted for mostly by a single drug being administered to farm animals ? It sounds like a shocking number but it means very little to me. Even a little more information would have been really helpful and help me feel like it wasn't a statistic created for wanton shock value.
Nullius in verba
First, get antibiotics out of agriculture, where they're given _all_ _the_ _time_ as a preventative measure. Stupid.
Second, why exactly should access be "fair"? TFA complains on moment that there's no economic incentive, and then promptly demands fairness. Get real. Life isn't fair. But what the rich can buy today will be available to the rest of us tomorrow.
Enjoy life! This is not a dress rehearsal.
Politicians care about themselves and their ability to remain in power. If they can kill soldiers and remain in power, they will do so. If they can ignore a health crisis and remain in power, they will do so. If they can drag their feet while pretending to address an issue, they will do so. If, however, an issue directly affects them, they'll rapidly act to address it.
To show that this hasn't changed for hundreds of years, I give you The Great Stink of 1858. (WARNING: Do not watch while eating.)
My sci-fi novel, Ghost Thief, is now available from Amazon.com.
Ancient texts show that people have brewed up useful concoctions that may be of incredible value today. Always have an open mind.
http://www.smithsonianmag.com/...
What we urgently need to do is to learn to let people die.
On a global scale, the use of antibiotics is more of a problem than the shit we use them against.
Humans are just a phase.
Good thing we have the for profit industry in the US. With all those dollars guiding them we should have a solution by next week. Of course, only the 1% may be able to afford it anyway, but citizens in single payer countries will be ok.
Laws are rules for the court, but merely a bottom bar to hit for life. Think beyond laws in your actions always.
Skinner: Well, I was wrong. The predatory bacterial strains are a godsend.
Lisa: But isn't that a bit short-sighted? What happens when we're overrun by predatory bacterial strains?
Skinner: No problem. We simply unleash wave after wave of Chinese needle snakes. They'll wipe out the predatory bacterial strains .
Lisa: But aren't the snakes even worse?
Skinner: Yes, but we're prepared for that. We've lined up a fabulous type of gorilla that thrives on snake meat.
Lisa: But then we're stuck with gorillas!
Skinner: No, that's the beautiful part. When wintertime rolls around, the gorillas simply freeze to death.
While this will be a tragic turn of events for millions or even billions of people, ultimately we will be forced to seek a new path of technology to sustain our bad behavior. As they say, "necessity is the mother of invention". It will be a long hard road but we will reach the end and develop something akin to synthetic microbes that do exactly what they are programmed to do. Frankly, with the last few centuries so focused on killing each other, humanity could use the diversion to actually work on protecting ourselves from the ever-present invisible enemies that are microbes.
It's a hard road we face but after much death and suffering we will come out stronger as a species.
Anons need not reply. Questions end with a question mark.
https://www.amazon.com/Herbal-...
but not for the reasons you're probably thinking. Those words weren't uttered by a government agent (one of those paid for my kid's cancer treatments and the research that made those treatments possible). They come from a right wing think tank. They were engineered to make the working class turn on each other and on the primary source of organized power they possess: Democracy.
Worked too.
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and existed before the complex games companies play to keep things in patent control.
And yes, they were massively funding research. Not into new antibiotics, because that's a fairly recent issue (last 20 years tops). But the cancer drugs that kept my kid alive were invented by the government (or Europe, research into childhood diseases isn't profitable enough to do it here in the States and, well, aforementioned tax cuts).
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Geezus, I keep posting this. Antibiotics are great and all, and limiting nonessential use is great and all, but we really need a Plan B. A serious alternative way of treating drug resistant infections.
And we already have it!
It is called phage therapy and it is completely different. Viruses have been attacking and eating bacteria for literally billions of years. This predates multicellular organisms and so we already know how effectively bacteria can develop immunity to viruses (hot tip: they can't! If they could have they would have done it a billion years ago).
Chances of the virus attacking and killing the host? Zero. Not close to zero, not almost zero, it's zero. Bacteriophages are 100% specific to their preferred bacterial victims. They won't even attack and kill familial relationship bacteria; it has to be an exact match or the virus will remain inert and harmless.
The Soviets pioneered the use of phage therapy and they are the acknowledged experts in this field. Western medicine has blinders on when it comes to the promise of phage therapy because it was NIH, it's not pharmaceutical, and monetizing it is problematic (it could be done but most believe it cannot be patented).
What ridiculously hyperbolic garbage.
If we weren't so focused on the failing strategy of "look for MOAR antibiotics", we could have had the superbug problem licked already with alternatives like phage therapy (which you can only get right now if you fly to Georgia).
What does it tell you when the famed "merkan innovation" can't even out innovate a tiny former soviet republic using 90yr old tech?
Yeah, thought so.
medicine would only be returned to about its state in 1910, or perhaps 1900
Incorrect, due to a number of factors: in the early 1900's, most people weren't subsiding on diets primarily consisting of nutritionally-devoid, pesticide-ridden, genetically-modified sludge processed primarily from wheat, corn and soy. They received more exercise on average as well as more sunlight (the pharmaceutical industry's efforts to vilify sunshine - one of the most important parts of a healthy lifestyle and an obvious threat to their profits - have been wildly successful) and lived far less complicated, stressful lives.
It'll be a royal shitshow... and go a long way towards mitigating the population problem. Sit back and enjoy your [ADM; Cargill] factory-farmed popcorn. :)
Between climate change and overpopulation isn't this just a way to cull the herd? People survived before antibiotics, and the genetically strong will survive the loss of antibiotics. It won't be pretty though.
The fact that we even have germ theory is a huge improvement over even the 1800s. The advances we have that antibiotic resistance can't negate include, but are not limited to:
These advantages put is far above our ancestors, for example we're not all going to suddenly get cholera just because it's become resistant to antibiotics. Even with antibiotics, the Bubonic Plague is still absurdly lethal, but in modern times we have been able to contain outbreaks because we understand its transmission vectors.
*we've been letting the first three slip away from us, probably because we've been so sure of our ability to stop infections after they've started.
Drug companies that do research into antibiotics get access to government grants, Those that don't and stick to only profitable drugs obviously don't need the lep so they are denied access.
Sorry, teleporters just kill you and then make a copy. A perfect, soul-less copy.
Ending profit as a primary incentive? First you would need to remove money from being able to influence politics and regulation. Good luck.
The story reminded me of this video where researchers demonstrated the readiness at which bacteria can adapt to antibiotics. It is fascinating to see evolution in action.
Tell the dog owners.
This shit has been circulating for decades.... nothing to see here.
If we want to preserve antibiotics effectiveness, we need to stop giving them to not-yet-ill cattle. to prevent infection outbreak in industrial farms. The guts microbes of antibiotic-fed cattle will always grow resistant, and genes developed that way can spread to other microbes
Of course that would raise meat prices, and consumption should decrease. This is a pain to admit for a happy meat-eater, but the alternative of kissing antibiotics goodby is not appealing.
"What does a Cro-Magnon need with a street?"
Ezekiel 23:20
We don't need "pills" when we will have microscopic robots that can battlebot bad bacteria and win every time.
Or at least hold off until the actual subjects of TFAs have been discussed for a bit.
I'm getting really tired of scrolling past several screens of political non sequiturs to get to the actual meat of the discussion.
Yes, I know Carthage Must Be Destroyed. But at least Cato had the grace to wait until AFTER he'd made his points on the actual business at hand before he'd sign off with that.
Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
Not all bacteria are harmful. This phage therapy needs to not wipe out the symbiotes that make it possible for us to stay alive.
Actually it's going the other way around :
- Antibiotics are rather indiscriminate and can kill large swaths of bacterial population, including commensal flora (= "the bacteria which normally live here", i.e.: non-dangerous).
That's one of the reasons (the non-ecological/resistance one) why doctors try to avoid over-prescribing. (Just ask any girl who got yeast infection - e.g.: candida - because her flora got disturbed by a wide-spectum antibiotics)
That's also a reason why antibiotics can be prescribed with micro-flora supplements (the antibiotics will kill the commensal flora in addition to the bacteria causing the disease you're trying to cure, so you need to import new microorganisms to compensate - usually Saccharomyces, a type of benign yeast)
(Disclaimer: IAAD)
- Phage are the bacteria equivalent of viruses. They target *specific* surface receptors. It's like viruses and eukaryote (you might catch flu from a swine because surface cell receptors are close enough for a virus targeting one to be able to bind the other - ie. we're closely enough related. You'll probably never catch a virus usually affecting plants.)
A phage might be able to recognize and bind a few related bacteria, but will never affect other completely different prokaryotes).
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
If you invest $1B+ bringing a new antibiotic to market, but only manage to make $100M before it goes off patent (or $0 if it fails in phase IV clinical trials), you can't sustain that.
It all depends on who's doing the investement.
- Public sector - i.e.: countries investing in their universities - do *NOT* need to make a return on investment (i.e.: sell a profitable drug), they only want to make the science progress.
The problem, is that the budget necessary is beyond the financial means they can invest into a project.
i.e.: your government would gladly pay you to try new anti-biotics but doesn't have the money to it.
- So, nowadays, these investment are handled by pharmaceutical companies to whom this is really within budget - not to say small change (these sums looks probably like rounding errors next to their marketing budgets). But, as companies, they have to think about profitability.
i.e.: they would have the money but don't want to throw it away on something that will never make profit.
- Thankfully we start to see whole continent-level academic collaboration (e.g.: universities accross whole europe), and now financing projects all the way to clinical use is within the financial reach of publicly funded projects.
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
Phage therapy {...} bacterias will also evolve resistance against it.
Luckily for us, bacteriophages themselves - as a type of primitive parasitic semi-life form, similar to viruses - are also subject of evolution and are also under evolutive pressure to adapt to keep having access to hosts in order to be able to replicate.
They also replicate on a much higher speed than bacteria, meaning that they are much faster affected by evolution.
(i.e.: it is realistically possible to imagine keeping culture of semi-resistant bacteria and trying to grow phages on them and get those to evolve.
You might end up with mutated phages who'll be better at attacking these specific bacteria).
This is unlike the pharmacochemical industry which needs to come up with new formula of their own.
This is also less like the various yeasts which through evolution have came up with solutions against their resources competitors, and have historically been where antibiotics have been discovered. (Yeast does evolve, but at a much slower pace. A culture of yeast and semi-resistant bacteria is most likely to end up with the yeast starving).
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
Appears a global issue that global orgs like UN should help lead. While read a few news briefs UN , WHO recognize issue the actions seem limited for the larger issues mankind has cooperating. What should an ave person do to help? First, don't abuse antibiotics. Next, possibly Push your politicians if you are able. Meanwhile entertainment, games etc. businesses continue to grow. Priorities?
Once again, we've let our perverted obscession for profits to override self-preservation of the species. The downfall of using capitalism as the only tool of economics.
PlaynBass
No white-faced villager in the dark ages with a raging fever or galloping liver spots waited ten years to bosom the cross and quaff the latest available snake oil adorned with even the sketchiest reputation of hope.
Yes, we might fall back a giant rung on the ladder of exigency if we can't see our way to escape the wet-paper bag of market forces.
Meanwhile, North Korea.
Why is this even up for discussion? I know from personal experience in Cancer that in the 1980s it was a mis-mash of science. If you had lung cancer in 1985 the conventional wisdom was to write out your will today because it's not going to be very long. Today people walk around and can live for decades with lung cancer. Of course it depends on which type. However today there is a whole protocol around it. Doesn't matter if you go to the Mayo clinic, John Hopkins or Nowhere's ville Montana. They do the same tests, send them to the same places and the treatment is all the same. I've seen it over and over again across the country. And this is Cancer.
So how come with antibiotics, why is this so hard? All they have to do is publish the wisdom of when to use them and when not to. Patient insists on something - Tough. We also need a campaign in schools and in the public to get people to take their medicine as directed and not stop because they feel better. I run into people all the time that stop because they feel better and they don't want to "get hooked", or take drugs needlessly... and some other excuses.
Seems like this one isn't that hard to fix.