I grew to believe in advanced progress in science and medicine – that human health will continue to increase as it did for hundreds of years. When I developed through my own career in health science, I continued to be optimistic.
Now I have serious doubts.
Science still works well, but the deadly obstacle blocks the way between research and progress in the field where I work: Antibiotics.
The threat to humanity is the grave and worsens day by day, but for reasons that prevent my colleagues and me, there seems to be a very small collective desire to do many things about it.
This week (November 12-18) is the World Antibiotic Awareness Week. We need to talk about this threat. We need to develop a model of public-private cooperation – to provide incentives, fund and invest in the discovery and development of antibiotic drugs.
Penicillin causes complacency
This is the problem: about 75 years ago, science brought penicillin to public use, opening up a new era in infectious disease control, just as previous sanitation had done. Infectious diseases such as pneumonia and inflammation, which are generally fatal even on my grandparents' day, are tamed – at least for a while.
In subsequent generations, life expectancy has increased by 25 years and infectious diseases have fallen from No. 1 one place among all causes of human death, where he consistently ranks higher than bullets and bombs – even during World War.
With cheap, abundant and effective antibiotics at hand, people in developed countries become satisfied in controlling infections.
But so far, while we are living better, living longer, infectious diseases have worked again, and today they are pounding on the door. In fact, they have broken the door.
The market will not meet demand
In a quick example of Darwin's adaptation through natural selection, bacteria and other microbes develop to survive antibiotics. They will continue to adapt and they will succeed unless humans build new layers of defense in the form of new antibiotics and other creative approaches.
The world government recognizes the crisis, as they stressed at the special summit of the United Nations General Assembly in 2016 and at the G20 in 2017.
The difficult part is that we know what we have to do to create new antibiotic therapy, and even though the work is undeniably difficult, there are already several promising new alternatives for older drugs, and many more are being screened.
Unfortunately, they are not yet available in the commercial market, and they may never get there unless something changes to make it feasible – not as medicine, but as a commodity.
The critical obstacle to producing new antibiotics turns out to be our own economic model, which trusts the market to meet demand. The invisible hand, like the philosopher and economist Adam Smith calls it, does not work here, and what is at risk is all the progress made by antibiotics.
Canada can lead the struggle to live in the post-antibiotic world
The public model is risky
Last summer in the United States, two pharmaceutical companies received FDA approval for new antibiotic compounds. As soon as the market learned that the companies had created drugs that could truly save the world, their shares fell.
That sounds counter-intuitive, right? It turns out that spending hundreds of millions to make, test and market new drugs is a bad risk unless the drug can recover investment in 20 years before the patent ends.
That's hard to do when you try to recover the cost of one recipe 10 days at a time. And when you prescribe a new drug only for infections that cannot be solved with cheap traditional antibiotics, which still function in many cases.
The only way to make business sense to create a new antibiotic is to make it expensive astronomically, in the range of rare cancer drugs, and who will pay for it?
Many argue that we should look at antibiotics just as we see the fire department. As individuals, we may never need it, but we are all willing to share costs, because we expect them to be there.
The public model seems reasonable, but who will take political risks?
The hospital is threatened
Without intervention – where communities, through their governments around the world, work with the private sector to help provide incentives, fund and invest in the discovery and development of antibiotic drugs – the end of effective antibiotics will be daunting.
That will happen gradually, but it will definitely happen. The first stage is already here in the form of antibiotic-resistant infections that threaten the basic functions of the hospital.
Next, we will look at general procedures such as dental hygiene appointments and permanently canceled joint replacement surgery because of the risk of infection.
People of all ages will start dying again from the diseases we have used to treat with pills of $ 10 or $ 20. Those who do not die will get sick more often and for longer, raising the cost of care.
Life expectancy could fall back into place in the early 1900s, and the golden era of antibiotics will prove to be short, happy blips in history.
It doesn't have to be like this. Let's turn our awareness into action.