A New York Times Editorial points us to the World Health Organization’s recent report on the resistance bacteria, viruses, parasites, and fungi are developing to the drugs we’ve developed to control them. The long-term danger is that some species of microbes will overcome all the drugs made to control them. We could enter a world where the danger of infection makes surgery too risky. We’d live our lives differently because minor wounds could turn fatal. Pneumonia used to be the number one cause of death between 1900 and 1937. Without antibiotics, we could see those days return.
This is a serious situation. Resolving it is another case in which we run smack into conservative ideology and its current over-estimation of the value of free markets.
The Market Will Save Us
Following current conservative thinking, if there is a need for new antibiotics demand will increase and the force of the market will pull pharmaceutical companies into the breach to fill the unmet need. That does not accord with the facts, though. We’ve had problems with antibiotic resistance for decades and the last new class of antibiotics was discovered in 1987 – a quarter century ago. The market has clearly not provided adequate incentive.
Why is that? Unlike drugs for chronic conditions like high cholesterol or diabetes, antibiotics are generally only used for a couple weeks at a time, at the very most ninety days. Proving safety and efficacy of antibiotics is not easy and is fraught with ethical questions. So pharmaceutical companies just haven’t invested in them.
Why We Have This Problem
The reason we have this problem to begin with is that 70% of antibiotics are being fed to animals. Partly that’s due to how we raise animals. Cows develop dyspepsia on an all-corn diet and get much more susceptible to illness. Pigs are now raised so close together that their tails are commonly removed so they won’t bite one another. Animals so close together are at greater risk of spreading disease to one another.
But the real reason is that small, sub-therapeutic doses of antibiotics are administered to livestock on a large scale because it makes them grow faster. For example penicillins are typically fed to pigs to promote growth.
Do you know what else administering sub-therapeutic doses of antibiotics does? It encourages the growth of bacteria resistant to the antibiotic. It’s simple evolution. With a smaller dose, slightly resistant bacteria survive. They can reproduce and form even more resistant bacteria.
As of today, the livestock industry has “voluntary” guidelines to restrain them. You don’t have to be an expert in game theory to realize that every livestock company continues to have an incentive to ignore these guidelines or, better, to pretend publicly to be meeting them while flouting them privately.
This is a clear case where regulation is required and urgently to protect our way of life, but conservative ideology stands in the way of getting things done that need to be done. It wouldn’t be a bad thing either if government would begin to fund research into new classes of antibiotics.