Remember Life Before Antibiotics? No? Wait, It'll Come to You

Photographer: Aslan Alphan/Getty Images

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Photographer: Aslan Alphan/Getty Images

Humans, we’ve got a problem.

After a century of gains in the war against infectious diseases, we’re losing ground. Common bacteria, parasites, viruses and fungi are developing widespread immunity to some of our best weapons. Imagine a world where an uber-resistant staph infection could mean death by a paper cut.

Serious drug resistance is already developing, and it could get much worse, according to a new report by the World Health Organization:

The world is heading towards a post-antibiotic era, in which common infections and minor injuries, which have been treatable for decades, can once again kill.

Humanity's war on microbes is an arms race. We develop drugs to treat the bugs, and the bugs develop ways to get around them. What's got scientists concerned is that the humans have pretty much stopped producing new classes of antibiotics, and bacteria are getting better at evading our tricks. It almost brings us back to a pre-antibiotic era, when people died from simpler causes than the chronic diseases that top the charts today.

Source: WHO

Source: WHO

The WHO report is one of the most comprehensive analyses to date on the global reach of drug resistance, drawing on data from 114 countries. Looking at seven common bacteria, from bloodstream infections to gonorrhea, the global health body found high levels of resistance in every region of the world.

Drug resistant tuberculosis now affects 630,000 people. Drug effectiveness is declining for serious diseases like malaria, HIV and the flu. Ten countries have reported cases of gonorrhea that don't respond to any antibiotic.

Many drugmakers abandoned antibiotic R&D years ago. New antibiotics cost the same to develop as drugs for diabetes or heart disease but bring in less revenue. Courses of antibiotic treatment typically last weeks instead of years or decades of treatment for chronic illness. Companies still doing antibiotic research include Cubist Pharmaceuticals Inc., Merck & Co. and Sanofi.

It’s not clear if the new drugs under development will be able to keep up with rapidly evolving antibacterial resistance caused by overuse. Bacteria are fast learners, and we’re giving them lots of practice. Roughly 80 percent of antibiotics in the U.S. go to farm animals. Half of the antibiotics given to humans are prescribed for viruses like colds and the flu, which don’t respond to antibiotics.

In some ways, we’re already living in a post-antibiotic era. Death by paper cuts may never be a common killer (let’s hope), but doctors are increasingly facing the grim reality of common bacterial infections like urinary tract infections and pneumonia that don’t respond to any treatment in the physician’s toolbox. If those bacteria overtake their drug-vulnerable cousins, it could spell an epidemic of fiercely destructive illness that’s rarely been seen in the age of modern medicine.

When Scottish scientist Alexander Fleming discovered penicillin in 1928, it was a medical miracle, stopping deadly diseases in their tracks and extending the human lifespan in ways as transformative as vaccines and modern sanitation. That was the same year the New York metro area got its first major airport (across the river in New Jersey).

By 2050, the human population will be almost 10 billion people, five times bigger than any time in the pre-antibiotics era. That’s almost 10 billion perfect carriers of drug-resistant disease, and this time they’ll be flying on planes.

For a primer about the causes of antibiotic resistance see this Bloomberg Quicktake. For a deeper dive check out “Imaging the Post-Antibiotics Future” by global health writer Maryn McKenna. Last year the CDC also put out a consumer-friendly report on antibiotic-resistant threats.

More from Tom Randall:

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