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We need co-ordinated action on new antibiotics

The discovery of penicillin by Scottish doctor and bacteriologist Alexander Fleming in 1928 has arguably been the single greatest boon to medical science of the last century, leading to the development of a whole arsenal of antibiotics.

Where once a minor flesh wound could result in infection and death, now bacterial infections of all sorts can be overcome by taking a few little pills.

A world where routine infections were resistant to antibiotics and other antimicrobials would be a much more dangerous place to live.

Yet that is what could lie in wait unless countries around the world take coordinated action to get a grip on the problem of microbial drug-resistance.

That stark warning yesterday by Mark Woolhouse, professor of infectious disease epidemiology at Edinburgh University, was not exaggerated; sadly, the evidence for it is only too clear. Superbugs such as MRSA are already a major problem. As Professor Woolhouse and his colleague Jeremy Farrar, of the Wellcome Trust, point out, "every class of antibiotic is increasingly compromised by resistance, as are many antivirals, antiparasitic and antifungal drugs".

Microbes naturally evolve to become increasingly resistant to drugs, but the overuse of those drugs speeds up the process. The Netherlands has strict guidelines on prescribing antimicrobials and there are consequently low rates of resistance there, but in many countries, particularly but certainly not exclusively in the developing world, the drugs are handed out more freely or in an unregulated way. In India and Pakistan, 95% of adults carry bacteria that are resistant to one class of antibiotics, compared to only 10% of residents of Queen's, New York.

Resistant strains of infection do not respect national boundaries, so no nation can afford to be complacent. Not nearly enough new antibiotics have been developed in recent years to replace the ones that are becoming ineffective, a problem the scientists blame on lack of incentives for drug companies and too many regulations.

Coordinated international action is clearly required with countries worldwide acting in tandem to tackle the problem. Professor Woolhouse has called for the creation of an equivalent of the IPCC (International Panel on Climate Change) for antimicrobial resistance and the idea ought to be adopted at once. The IPCC has its detractors, but it remains a hugely powerful means of marshalling scientific consensus to chivvy politicians into action.

The new body would have several important functions, including acting on the misuse of antimicrobials and stimulating the development of new drugs. Better surveillance programmes are also needed so all outbreaks of drug-resistant bugs were reported and carefully monitored.

Without concerted action, it seems worryingly clear the human population could lose some of the most potent weapons in its medical arsenal. International coordinated action led to the eradication of small pox; this is an even bigger goal and developed countries such as the UK ought to be taking the lead in the global fight back.

Contextual targeting label: 
Drugs

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