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The Guardian view on antibiotic resistance: walk softly, carry a big stick The Guardian view on antibiotic resistance: walk softly, carry a big stick
(about 1 hour later)
The Longitude Prize is a very smart idea. The prize is a handsome £8m and it awaits the first individual or (more probably) team that develops a quick, cheap and reliable way of stopping overuse or misuse of antibiotics. The diagnostic – it might be a strip of sensitised paper or it might be a mobile phone app – must be capable of being used anywhere in the world. Next week another round of assessment of ideas begins from the 138 teams so far registered. The Longitude Prize is a very smart idea. The prize is a handsome £8m and it awaits the first individual or (more probably) team that develops a quick, cheap and reliable way of stopping overuse or misuse of antibiotics. The diagnostic – it might be a strip of sensitised paper or it might be a mobile phone app – must be capable of being used anywhere in the world. Next week another round of assessment of ideas begins from the 138 teams so far registered.
A prize is smart economics to encourage smart science. It counters the lack of a strong market incentive to develop a diagnostic for which there is an overwhelming need – while reminding the rest of us to remember, next time we see the doctor, the urgency of the crisis. Antibiotics, it is reckoned, add 20 years to life expectancy; resistance is growing so fast that already 700,000 people die each year from untreatable infections. From the exotic, like typhoid, to the all too domestic Clostridium difficile, the pathogens that once succumbed swiftly to penicillin and other antibiotics now fight back. They are becoming killers again.A prize is smart economics to encourage smart science. It counters the lack of a strong market incentive to develop a diagnostic for which there is an overwhelming need – while reminding the rest of us to remember, next time we see the doctor, the urgency of the crisis. Antibiotics, it is reckoned, add 20 years to life expectancy; resistance is growing so fast that already 700,000 people die each year from untreatable infections. From the exotic, like typhoid, to the all too domestic Clostridium difficile, the pathogens that once succumbed swiftly to penicillin and other antibiotics now fight back. They are becoming killers again.
Finding a diagnostic that can be made universally available isn’t going to save the world. But as the economist Jim O’Neill argued in his report on antimicrobial resistance published last week, when more than half of all prescriptions for antibiotics may be unnecessary, developing a globally available test is going to be part of the solution to keeping them viable for another generation. Antibiotic resistance arises when a drug wipes out the weediest organisms in a population, leaving hardier ones behind that pass on their genes. Then, when this next generation is hit with drugs, the weediest of those are killed off, leaving a bunch behind that are hardier still. Simply reducing the number of times a type of bacteria is challenged might, counter-intuitively, stop it growing more resistant. Walk softly and carry a big stick. Finding a diagnostic that can be made universally available isn’t going to save the world. But as the economist Jim O’Neill argued in his report on antimicrobial resistance published last week, when more than half of all prescriptions for antibiotics may be unnecessary, developing a globally available test is going to be part of the solution to keeping them viable for another generation. Antibiotic resistance arises when a drug wipes out the weediest organisms in a population, leaving hardier ones behind that pass on their genes. Then, when this next generation is hit with drugs, the weediest of those are killed off, leaving a bunch behind that are hardier still. Simply reducing the number of times a type of bacteria is challenged might, counter-intuitively, stop it growing more resistant. Walk softly and carry a big stick.
Economics isn’t working here. That’s partly why new generations of antibiotics emerge so infrequently. Earlier generations are now cheap and plentiful and increasingly ineffective. New ones are very hard to develop, and might never be licensed for mass distribution but instead reserved as a weapon of last resort. There’s not much profit in either. Lord O’Neill proposed a “play or pay” levy on big pharmaceutical companies; the ones that didn’t invest in research and development would be required to help those that did. The industry reaction was negative.Economics isn’t working here. That’s partly why new generations of antibiotics emerge so infrequently. Earlier generations are now cheap and plentiful and increasingly ineffective. New ones are very hard to develop, and might never be licensed for mass distribution but instead reserved as a weapon of last resort. There’s not much profit in either. Lord O’Neill proposed a “play or pay” levy on big pharmaceutical companies; the ones that didn’t invest in research and development would be required to help those that did. The industry reaction was negative.
The problem of antibiotic resistance is about science and economics, and it faces society itself, locally and globally, with hard questions, too. It pits individual benefit against the common good: your sore throat, our ability to survive a hospital stay. It demands recognition that a personal benefit may at a distance have a much greater cost.The problem of antibiotic resistance is about science and economics, and it faces society itself, locally and globally, with hard questions, too. It pits individual benefit against the common good: your sore throat, our ability to survive a hospital stay. It demands recognition that a personal benefit may at a distance have a much greater cost.
If that was the extent of the problem, it would be challenge enough. But it is much worse than that. The EU has banned the use of antibiotics in farm animals. In the US and China and many other countries, they are a commonplace growth enhancer. They deliver fatter pigs and bigger profits to farmers, more cheap food to swelling populations. All the cheap and effective diagnostic kits in the world will be futile if there is no agreement to end this rival abuse of scientific knowledge. Like climate change, there is only one big way to meet the threat. Together. If that was the extent of the problem, it would be challenge enough. But it is much worse than that. The EU has banned the use of antibiotics in farm animals. In the US and China and many other countries, they are a commonplace growth enhancer. They deliver fatter pigs and bigger profits to farmers, more cheap food to swelling populations. All the cheap and effective diagnostic kits in the world will be futile if there is no agreement to end this rival abuse of scientific knowledge. Like climate change, there is only one big way to meet the threat. Together.