I grew up believing the advances in advances in science and medicine – that human health would continue to improve for hundreds of years. As I reviewed my own career in health science, I continued to be optimistic.
Now I have serious doubts.
Science still works well, but deadly obstacles block the path between research and progress in the area where I work: Antibiotics.
The threat to humanity is grave and getting worse by day, but for reasons flying from my colleagues and me, it seems to be shocking little collective will to do much about it.
This week (November 12-18) is the World Antibiotics Awareness Week. We need to talk about this threat. We need to develop models for public-private cooperation – to stimulate, finance and invest in antibiotic treatment and development.
Penicillin led to self-esteem
Here's the problem: About 75 years ago, science came with penicillin for public use and opened a new era in infectious disease control, which sanitation had done before. Infectious diseases such as pneumonia and stroke, which were usually fatal even during my grandparents' day, were tampered – at least once.
During the generations that followed, life expectancy of 25 years and infectious disease tumbled from its first place among all causes of human death, where it had been consistently ranked higher than bullets and bombs – even during World War II.
With cheap, abundant and effective antibiotics at hand, people in the developed world became self-evident in controlling the infection.
But all the while, while we have lived our better, longer lives, infectious diseases have been working on recurring, and today they are dimming at the door. In fact, they are already breaking down the door.
The market will not meet demand
In a quick forward-looking example of Darwinian adaptation through natural selection, bacteria and other microbes develop to survive antibiotics. They will continue to adapt and they will succeed unless humanity builds new layers of defense in the form of new antibiotics and other creative approaches.
The governments of the world recognize the crisis, as they confirmed at a particularly high meeting of the UN General Assembly in 2016 and at the G20 2017.
The worrying part is that we know what to do to create new antibiotic treatments, and although work is unequivocally difficult, there are already promising new alternatives to older drugs, and more are under way.
Unfortunately, they are not yet available on the commercial market, and they never get there unless nothing changes to make them viable – not as drugs, but as raw materials.
The critical barriers to producing new antibiotics prove to be our own economic model, which relies on the market to meet demand. The invisible hand, as the philosopher and economist Adam Smith called it, does not work here, and what is at risk is all progress made by antibiotics.
Canada can lead the struggle for life in a post-antibiotic world
Public model is risky
In recent US summer, two drug companies have received FDA approval for new antibiotic compounds. As soon as markets learned, these companies had created drugs that could literally save the world, their stocks fell.
Sounds contra-intuitive, right? It turns out that spending hundreds of millions creating, testing and marketing a new drug is a bad risk unless the drug can return the investment within 20 years before the patent expires.
It's hard to do when you try to recover the cost a 10 day recipe at a time. And when you write the new drug only for infections that can not be solved with cheap, traditional antibiotics, which still work in many cases.
The only way to make business interests to create new antibiotics would be to make them astronomically expensive, in rare cancermedic drugs, and who would pay for it?
Many claim that we should look at antibiotics in the same way we look at the fire department. As individuals, we may never need them, but we are all willing to share the cost, because we expect them to be there.
A public model seems meaningful, but who takes the political risk?
Without intervention – where the public, through its governments around the world, collaborates with the private sector to stimulate, finance and invest in antibiotic treatment and development – the effect of effective antibiotics will be scary.
It will happen gradually, but it will certainly happen. The first stages are already in the form of multibiotics resistant infections that threaten the basic function of the hospitals.
Then we will see common procedures like dental staff and joint replacement surgery that has been permanently discontinued due to the risk of infection.
People of all ages will start dying again from diseases that we have become accustomed to treatment with $ 10 or $ 20 pills. Those who do not die will get sick more often and much longer, and increase the cost of care.
Lifetime can fall back to where it was in the early 1900s, and the golden epoch of antibiotics would prove to have been a short, happy blow in history.
It does not have to be like this. Let's make our consciousness into action.