Waves of grief and anger spilled out as my patient told me of her father’s death from an infection in a hospital down south following surgery.
It offered scant relief to tell her scientists at Newcastle University have been awarded funding for research to tackle the growing problem of ‘superbugs’, such as MRSA, resistant to antibiotics.
Around 25,000 people a year die from antibiotic-resistant infections in the EU; in Britain, it is estimated that MRSA and other infections such as clostridium difficile kill at least 5,000 patients yearly despite a Government drive to clean up hospitals. Around 70% of these infections are being attributed to sources outside hospitals; bacterial evolution continues unabated.
Drug resistance is a global threat that could cost 10 million lives annually by 2050 - more than now die of cancer – and cost the global economy $60 trillion to $100 trillion. A 2013 report by the UK’s Chief Medical Officer ranked resistance as serious a threat to society as terrorism, made worse by the fact that developing new antibiotics is unprofitable as it take years and these drugs can only be used sparingly. Profit, surely, cannot be the sole motive of an industry founded on making people better?
The problem goes beyond the overuse of antibiotics for humans. Farmed salmon eat their own weight in antibiotics. Food producers in the US use antibiotics liberally as growth promoters. A new EU report says farm animals account for about two thirds of all antibiotics used in 26 European countries; antibiotic-resistant E. coli in people is linked to overuse of antibiotics in farming.
Livestock-associated MRSA can transmit to humans and cause infections. Unlike most European countries, the UK has not undertaken extensive MRSA surveillance of its pig and poultry. Some 73% of fresh shop-bought chicken tested positive for food poisoning bug campylobacter in a year-long study by the Food Standards Agency.
Major retailers failed to reach industry targets to reduce the bug over the period of the study but the FSA said Marks & Spencer, Morrisons, the Co-op and Waitrose had since seen a fall in contamination.
Most European countries, including the UK, continue to permit farmers to routinely use antibiotics in pig and poultry feed and drinking water for ‘disease prevention’. Attempts to limit farm antibiotic use have failed nearly everywhere, except in the five Nordic countries and the Netherlands, which have successfully banned or reduced routine preventative use.
Perhaps 2015 will be the year we make progress; there are new antibiotics on the horizon. One, teixobactin, was discovered by employing a new twist on a traditional method: screening soil for bacteria that have evolved to kill their competitors. By looking for antibiotics in microbial ‘dark matter’ that has so far been difficult to study, scientists may be have found a route to drugs with the potential of at least 30 years resistance to even fast evolving bacteria.
For decades, patients behind the Iron Curtain were denied access to some of the best antibiotics developed in the West. The Soviet Union invested heavily in the use of bacteriophages – viruses that kill bacteria – to treat infections. Phage therapy is still widely used in Russia, Georgia and Poland, but never took off elsewhere. Western researchers and governments, in trials funded by the EU, are now giving phages a serious look.
Happily, a few industry leaders do recognise that pharmaceutical companies have a social responsibility to invest seriously in antibiotics but can others be persuaded to develop new medicines to tackle drug-resistant bacteria?
Draft plans to tackle the problem will be on the agenda of the upcoming World Health Assembly and the G7 summit next month. Ideas for funding and refilling the global antibiotics pipeline are coming from the independent review commissioned by the UK government, commendably led by the economist Jim O’Neill.
O’Neill proposes a global innovation fund of $2 billion over five years to boost research into new drugs and diagnostic tests. Most of the money will go to universities and small biotechnology companies and, rightly, big pharmaceutical companies would be asked to make substantial contributions to the fund.
What can you and I do?
- Do not ask your GP for antibiotics for minor illnesses
- Sign an Avaaz petition (https://www.avaaz.org/en/antibiotics_factory_farming_41/?fpla) calling for an end to the routine preventative use of antibiotics in farming.