I grew up with the belief in the advancement of scientific and medical development – that people's health will continue to improve for hundreds of years. As I continued my career in health sciences, I was still optimistic.
I have serious doubts.
Science continues to work well, but the deadly obstacles prevent research and progress in the field where I work: Antibiotics.
The threat of mankind is serious and is getting worse by the day, but for reasons that escape from my colleagues and me, it seems to be a bit of a shameful collective will to do a lot of it.
This week (12-18 December) is the week of World Antibiotic Awareness. We have to talk about this threat. We need to develop public-private partnerships – encourage, finance and invest in finding and developing antibiotic drugs.
Penicillin led to complacency
Here is the problem: about 75 years ago, science brought my penicillin for public use, opening up a new era of combating infectious diseases just as sanitation was done before. Infectious diseases, such as pneumonia and strep, which were often fatal even in grandparents' days, were tampered – for at least some time.
During the next generations, life expectancy accelerated by 25 years and infectious disease fell from one place to the cause of death among all the causes of constant bullets and bombs – even during World War II.
With a cheap, rich and effective antibiotic hand in a developed world, people are happy with the fight against infection.
But all the time, even though we've been living better, longer lives, infectious diseases have been re-used, and today they are struggling with the door. In fact, they are already breaking off the door.
Markets do not match demand
A fast-moving example of Darwinian adaptation through natural selection causes bacteria and other microbes to survive antibiotics. They will continue to adapt, and they will succeed unless humanity builds new defense materials in the form of new antibiotics and other creative approaches.
World governments recognize the crisis, as they confirmed at the Special High-Level Meeting of the United Nations General Assembly in 2016 and the G20 in 2017.
It is worrying that we know what we need to do to create new antibiotic treatments and although work is undeniably tough, there are already promising new options for older medicines and more are being done.
Unfortunately, they are not yet available on the commercial market and they may never get there unless something changes to make them viable – not as drugs but as commodities.
Critical barriers to new antibiotics prove to be our own economic model, which trusts the market to meet demand. An unparalleled hand, as philosopher and economist Adam Smith called it, does not work here, and what is at risk is all the progress made by antibiotics.
Canada could lead a struggle for life in the antibiotic world
The public model is dangerous
In the US last summer, two pharmaceutical companies deserved FDA approval for new antibiotic compounds. As soon as the markets learned, companies had created medicines that could literally save the world, their stocks fell.
Sounds anti-intuitive, right? It seems that hundreds of millions of people in the creation, testing and marketing of new medicines are a bad risk unless the drug can make investments within 20 years before the patent expires.
It's hard to do when you try to replace the cost of one 10-day recipe at a time. And once you've determined a new drug for infections that can not be solved by the cheap, traditional antibiotic, which still works in many cases.
The only way it would make sense to create new antibiotics would be to make them astronomically expensive among rare anticancer drugs and who would pay for it?
Many argue that we should look at antibiotics in the same way as we look at fire departments. As individuals, we may never need them, but we are all willing to share the costs because we expect them to be there.
The public model seems sensible, but who takes political risk?
Hospitals under threat
Without intervention – when the public, through its governments around the world, cooperates with the private sector to encourage, finance and invest in finding and developing antibiotic drugs – the end of effective antibiotics is frightening.
It happens gradually, but it certainly happens. The first steps are already here in the form of many antibiotic-resistant infections that threaten the basic functioning of hospitals.
Next, we will see general approaches such as dental hygiene appointments and joint substitution treatment, which is permanently withdrawn because of the risk of infection.
People of all ages begin to die again of the illnesses we are used to to treat the pills for $ 10 or $ 20. Those who do not die will get sick more often and much longer, increasing the cost of treatment.
Life expectancy could return to the place where it was in the early 20th century, and the golden era of antibiotics proved to be only a short, happy history.
It does not have to be this way. Tell us about the action.