By SAHIL CHAUDHARY (NHS ‘17)
On a chilly December evening in 1945, the father of modern antibiotics, Sir Alexander Fleming, made a prediction that left many gripping for the edge of their seats. During his Nobel Peace Prize lecture, Fleming claimed that bacteria would eventually develop resistance to antibiotics such as penicillin. The monster pathogens that Fleming envisioned are beginning to emerge with frightening consequences; they kill 23,000 Americans each year. Many researchers believe that if these microbes are left unchecked, they could cause as many as 317,000 American deaths annually, beginning in 2050. To make matters worse, the development pipeline—a term used to describe the pharmaceutical industry’s drug development process—is “drying” of therapies to treat antibiotic-resistant-bacteria. The Infectious Diseases Society of America notes that from 2003-2007, the largest pharmaceutical firms produced only five antibacterial agents. Since market forces have failed to provide the financial incentives for antibiotic-resistant-bacteria treatments, the Federal government needs to take the lead in mitigating the threat posed by these deadly pathogens.
Bacteria’s evolution into antibiotic-resistant-agents mainly occurs in agricultural facilities and hospitals. The Centers for Disease Control and Prevention (CDC) estimates that agricultural facilities, such as poultry farms, consume about 80% of all antibiotics distributed in the United States. Agricultural facilities use antibiotics to accelerate the growth of livestock and reduce infections in crops. When agricultural workers use antibiotics to eliminate bacteria, those pathogens that contain genes for antibiotic resistance mature and reproduce, whereas the microbes that lack such genes die out. As a result, successive bacterial generations are all armed with antibiotic resistance. Americans, consequently, are more likely to ingest antibiotic-resistant-pathogens when they eat antibiotic-treated food. Currently, foodborne pathogens account for 22% of all antimicrobial resistance cases in the United States. Many health experts believe that this number will only rise as more pathogens gain antibiotic resistance. Gram-negative-bacteria also emerge from hospitals since clinicians tend to over prescribe antibiotics, which needlessly exposes bacteria to these potent drugs and creates antibiotic-resistant-pathogens. Evidence for the overuse of antibiotics comes from a recent CDC report, which found that a staggering 50% of antibiotics are prescribed incorrectly. Dr. Tom Frieden, a noted infectious disease specialist and director of the CDC, has consequently labeled hospitals as one of the most acute sources of antibiotic-resistant-bacteria. Any effort to mitigate the threat of these deadly pathogens will require addressing antibiotic use in agricultural facilities and hospitals.
The American people and their economy pay the price for the superbugs that develop in agricultural facilities and hospitals. Gram-negative-bacteria infect nearly two million Americans each year, many of whom never fully recover. Health experts estimate that treating antibiotic resistant infections costs the United States about $20 billion a year. Some health economists also believe that gram-negative-bacteria cost the United States another $35 billion a year in the form of lost productivity. Antibiotic-resistant-bacteria are clearly dangers to American society that need to be dealt with now.
One might expect that pharmaceutical firms would respond to this danger by investing research and development (R&D) dollars in products that eliminate antibiotic-resistant-pathogens. Pharmaceutical companies, however, have shied away from developing such treatments since cancer drugs are projected to generate more revenue. In other words, pharmaceutical firms stand to make more money selling cancer drugs than treatments for antibiotic-resistant-pathogens. Since healthcare markets do not create the incentives for such products, the Federal government must intervene with legislation that directs funding for research and development to gram-negative-bacteria projects.