Life as we know it could end in ten years if we don’t start taking drastic action. This is the message to come out of a new report by the World Health Organisation (WHO), their first look at antibiotic resistance around the world. The report finds that antibiotic resistant superbugs are present in every region of the world and that many countries lack even the basic systems to track and monitor them. It also highlights that microbes responsible for gonorrhoea, urinary tract infections, pneumonia, bloodstream infections, infections in newborns and intensive-care unit patients are now resistant to the most effective antibiotics used to kill them.
“Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” says Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security.
Alongside vaccines, antibiotics are arguably one of the most important discoveries in medical history. In antibiotics, humans are exploiting the weapons produced as part of an arms race that has existed between microbes for millennia. The first antibiotic was used to treat people in 1937 and not long after that we became aware of the other side of the microbial arms race – that microbes can become resistant to these wonder drugs. Resistance to penicillin was known before the antibiotic even came into use.
Latest estimates put the number of potential antibiotic resistance genes that exist at more than 20,000. But it doesn’t end there, microbes have crafty ways in which they can share resistance genes among themselves, and this has exacerbated the problem. It’s not just a case of each species of bacteria having to develop its own resistance mechanism each time they come into contact with an antibiotic. Instead, different species of bacteria can share the genes with each other.
The fact that antibiotics have been is use for over 80 years, and it is only now that the WHO have produced their first global report on the state of antibiotic resistance, shows just how much we underestimated the impact antibiotic resistance would have. The report highlights what microbiologists have been shouting for a while now, that a world without antibiotics is a scary place, and we are likely to be living in that world in as little as ten years.
The report has a clear call for action on a number of fronts. It urges individuals to only take antibiotics when necessary and to complete their course. It urges health workers and pharmacists to do all they can to prevent infection and to prescribe the right antibiotics only when they are really needed. It also urges policymakers to regulate and promote the appropriate use of antibiotics in medicine, veterinary practice and agriculture.
In addition to these measures, it is clear that we also need new antibiotics, more vaccines and novel ways to tackle infectious microbes and the WHO placed fostering research and developing new tools as a way that policymakers and industry can help. Earlier this year, the UK held a parliamentary review of antibiotic resistance and President Obama recently announced he was committing $30 million annually for the next five years to detect and prevent infections in the USA.
So what is New Zealand’s government doing? Apart from trying to tackle the country’s shocking rates of rheumatic fever, not a huge amount. The recent inter-institutional application to set up an infectious diseases Centre of Research Excellence (CoRE) didn’t make the shortlist and infectious diseases were specifically excluded from the three health-related National Science Challenges announced by the government last year. In a country with increasing rates of infectious diseases, if tackling these aren’t a national challenge, then I don’t know what is.
UPDATE: There’s been a fair bit of media interest in this story. If you are interested you can see a clip of me talking about the issue on NZ breakfast TV here. Some people seem to have taken the call for us to develop novel ways to kill microbes as a sign we should be investigating complementary/alternative ‘medicines’. In fact, after I appeared on TV I was sent a tweet sending me to psychosomatic healing website. Let me be clear, we need new antibiotics, vaccines and innovative strategies to stay ahead of this apocalypse, not hand waving, magic water and the like.
When I wrote the post, the WHO report was still under embargo so I couldn’t link to it. You can now read it here. They have also made a handy infographic: infographic-antimicrobial-resistance-20140430