The World Health Organisation has warned about the rise of antibiotic resistant superbugs which pose an enormous threat to human health. These drug resistant bacteria are now responsible for approximately 700,000 deaths each year. It is predicted that by 2050, antibiotic resistant bacterial infections could overtake cancer as the leading cause of death globally. These predictions are dire.
Decades of reliance on antibiotics has meant that superbugs have adapted to resist the drugs we use, including so-called ‘last-line’ drugs. In fact, Australia’s rates of antibiotic use per capita is higher than many other OECD countries.
There is a lot of pressure on doctors to prescribe antibiotics in order to avoid any chance of infection, but they are also prescribed in case an existing infection is missed. Doctors are keen to avoid possible litigation, and to also appease hospitals, consumers and drug companies.
Doctors often feel they are at reputational or even economic risk if they don’t provide them. This is a problem as much of our antibiotic use is practically useless and actually contributes to the emergence of these resistant superbugs.
Research led by UNSW argues that this issue is a social problem, caused in part by paranoia over bacteria and expectations for swift intervention. The social, economic and political contexts surrounding our over-use of antibiotics and chronic misuse is an important part of combatting this issue.
The recent discovery by Australian scientists of a protein responsible for drug resistant bacteria is a promising step forward in the fight against superbugs. The protein, called EptA, causes multi-drug resistance by masking bacteria from both the human immune system and important antibiotics.
Despite the rise of these superbugs, antibiotic research is largely underfunded by large pharmaceutical companies because the payoff is low. Antibiotics are largely off patent and cheap unlike the more profitable cancer or heart medications. These medications can be taken for years, meaning more profits, while antibiotics are used for just weeks.
Creating new antibiotics for the market is also a very time consuming and expensive venture. New medications can cost in excess of $1 billion and take on average a decade to produce. These drugs need to be tested on hundreds of patients and there is no guarantee of them reaching the market. Only one in five antibiotics that enter the testing phase end up being approved by regulators.
While there is an urgent need for people to reduce their antibiotic usage, we also need to act quickly to find alternatives. It is clear that the big profit-motivated pharmaceutical companies are not capable of solving this problem, in fact they are a big part of the problem we face.
The pharmaceutical industry is not in the business of creating cures – they are in the business of creating customers in order to turn a profit. From their point of view there is more money to be made in treating illness rather than preventing them.
Only an entirely different approach will be capable of dealing with the superbug problem. Social and behavioural change is required to protect those antibiotics that still work. Removing the profit motive from the healthcare system, and increasing funding to it, would help facilitate this as doctors could be afforded more time with patients. This would allow them to do more thorough examinations, but to also explain the risks of antibiotic use to patients.
A public education campaign must be combined with investment into drug research and development programs. The only way to do this effectively would be to bring the big pharmaceutical companies into public hands. By removing the profit-motive we could focus our efforts on these pressing questions.
A publicly owned and controlled pharmaceutical industry co-operating with well-funded public universities would help us to eliminate duplication in the field of research and ensure that we are using all available resources in a coordinated way. Such an arrangement would be a model to be held up internationally and make cooperation more efficient on an international scale.
The problem of antibiotic resistant drugs actually highlights how the capitalist system is incapable of solving the major problems we face. In addition to resisting all cuts to science, healthcare and education, we need to fight for a world where people are put before profits.
By Amy Neve