The post antibiotic era is not an apocalyptic idea but a very real possibility. It signifies the day when the miracle drug of antibiotics no longer works. To avoid a future scenario where ordinary infections can kill, there is a need for opportunities to decrease overuse and deliver novel antibiotics to market.
Though still a niche in the food market, increasing consumer awareness is paving the way for a growing market in antibiotic-free food.
A mix of innovative approaches to R&D, new forms of financing mechanisms, and regulatory tools can help bring novel antibiotics to the market. It is an entirely new business model for antibiotics.
New diagnostic tools can help doctors prescribe narrow spectrum antibiotics which only target the bad bacteria at play. Precise diagnoses for precision treatment bring down overuse of antibiotics.
Communicable diseases are infectious diseases transmissible (from person to person) by direct contact with an infected individual or the individual’s discharges or by indirect means. Among the most serious communicable diseases are: hepatitis, HIV/AIDS, influenza, malaria, polio, and tuberculosis. Unprecedented population growth, accompanied by rapid urbanization, has resulted in an excellent environment for communicable diseases to flourish. Communicable diseases from a cold to Ebola can circulate the globe with near telephonic speed because of constant population
movement as a result of extreme weather events, conflict, migration, or travel.
Vaccines and antibiotics are the tools we have to fight communicable diseases. However, the treatment of these diseases is threatened by increasing drug resistance.
Many antibiotics belong to the same class of medicine, so resistance to one can mean resistance to the whole class. Resistance that develops in one context can spread rapidly to affect treatment of a wide range of infections and diseases. Some of these features are also true for medicines used to treat viral, parasitic, and fungal diseases, leading to the broader concept of antimicrobial resistance (AMR). If the problem is allowed to continue to grow, it will kill more
than 10 million people per year in 2050. One of the consequences is that the risk of disease spreading is heightened, and the risk of death is, in some cases, doubled. Already, 60,000 people die every year from causes related to AMR in the United States and Europe. Some estimates of the economic effects of AMR have been attempted, and the findings are disturbing. For example, the yearly cost to the US health system alone has been estimated at 21 to 34 billion USD, accompanied by more than 8 million additional days in hospital.
There are biological and societal reasons for AMR. The biological causes cover mutation; second, microbes with resistance genes survive and replicate themselves; and, third, gene transfer from drug resistance microbes.
The societal causes cover unnecessary use of antimicrobials, which accelerate AMR, inappropriate use resulting in survival of microbes, excessive usage in agricultural, and, finally, hospital
use where critically ill patients are given higher doses of antimicrobials than needed. On top of that, pharmaceutical companies have been accused of fuelling the antimicrobial resistance risk with improper management of wastewater when manufacturing the antibiotics, with antibiotics finding their way to the water people drink.
While existing antimicrobials are losing their effectiveness, there is also a decline in the development of new antimicrobials. If this trend continues, the arsenal of tools to combat
resistant microorganism will soon be depleted.
Global governance is not tackling the failure of markets to incentivize companies to develop new antimicrobial medicines when existing ones no longer work. With no confidence in a return on investments, pharma companies are reluctant to commit billions of dollars on research and development that might lead to new, more effective drugs. On the demand side, convincing patients and doctors that antibiotics cannot be overused is challenging. The political will to adopt controversial policies, including controlling the use of antimicrobial drugs in human health and animal and food production, is lacking.