Watch out for drug-resistant superbugs

With the year already past the half-way mark of January, we should by now be done with the euphoria of ushering it in. We should, nevertheless, expect it should have some good things to come out of it, albeit with some cautious optimism. As such, a situation of increasing concern looms that has been likened to the terrorist threat globally, though it has some good and bad news. It has to do with drug-resistant superbugs. First, to appreciate the bad news, let me paint the scenario some of us are either familiar with, or guilty of. A person feels unwell and, given his previous experience, he decides that the symptoms not only mimic, but are similar to those of a disease he has previously recovered from and therefore must “know” very well. The person buys drugs over the counter, say, antibiotics. He may complete the full dosage. Or, for some reason, he may not go the full medication. Failure to complete medication may be because of several reasons, underlining well known medical seeking behaviours. The person may fail to take the full dosage because of lack of awareness of the harm caused by taking half the dose in the long term, or because he can only afford half the medication. He could also buy the unprescribed drugs because he cannot access qualified medical personnel who will charge for consultation, and perhaps prescribe lab tests, meaning more money to be paid. This is only an example, but such erratic medical seeking behaviour is the recipe for superbugs (drug resistant bacteria), the threat of which has mainly been associated with failing antibiotic treatment. Some so-called multi-resistant bacteria have become resistant to many drugs. Antibiotic resistance has become a serious health threat, with infections that were previously treatable with standard antibiotic drugs — such as tuberculosis, gonorrhea and E. coli – now often needing to be tackled with more than one drug. A review commissioned by the British government and released last month brought this home (see Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations, December 2014). The review grimly observes that drug-resistant superbugs could kill an extra 10 million people a year and cost up to $100 trillion globally by 2050 if their rampant global spread is not halted. The review is a first in giving “a body-count and dollar-value sense of the post-antibiotic world that awaits us if we don’t take coherent international action.” In Africa, the estimate is that there will be well over 4 million deaths a year by 2050. It is such figures that are making it be likened to terrorism, if not worse. Already drug resistant infections kill hundreds of thousands of people a year and the trend is growing, underscoring the importance of effective antimicrobial drugs, and the increased urgency of their availability. Antimicrobials are a class of drugs that includes antibiotics, antivirals, antiparasitics and antifungals. And, that efforts have been underway to ensure their availability, is what could pass for the good news. Scientists at the Northeastern University in the U.S. report that a handful of soil from a field has yielded what may be the first of a new family of antibiotics. Tests in mice suggest it could kill a wide range of bacteria, including drug-resistant tuberculosis. It could be a while, however, before it is available. In another instance, Swiss scientists are testing a new “designer” form of the drugs that target the specific strains of bacteria causing an illness, so that the other strains are left unharmed and don’t become resistant. In yet another effort, scientists at a British university claim to have found the “Achilles heel” of a major group of bacteria. They say they have discovered a way in which drugs could attack the cell membrane of one of the three major bacteria groups, known as gram negatives and include E.coli and other potentially deadly species. If, and when, the research efforts prove fruitful, the only major hurdle will be large scale production. Pharmaceutical companies have not been investing in antibiotic research because there is insufficient return on investment, compared with drugs for chronic conditions such as diabetes and the like. But let’s get effective antimicrobials first. Their affordability and accessibility can always be sorted out. The writer is a commentator on local and regional issues.

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Watch out for drug-resistant superbugs