Opinion Pill poppers

Since the 1950s, when antibiotics were first introduced, common bacterial infections like a minor cut or a sore throat have stopped being deadly. Now, however, the first global review of antibiotic resistance conducted by the World Health Organisation concludes that bacteria are increasingly able to elude treatment. In this post-antibiotic world, therefore, conditions that could until recently be dealt with by routine prescriptions may once again prove fatal — unless, as the WHO warns, significant action is taken to change how antibiotics are produced, prescribed and used.

Over time, bacteria genetically mutate to enable them to produce enzymes that render antibiotics inactive, or they might eradicate a particular drug’s target. Initially, there may not be too many such bacteria, but eventually, selective advantage will allow resistant bacteria to dominate the population, if enough of them repeatedly encounter the antibiotic. So when drugs are used too often and incorrectly, or when they are used in animal feed by the meat industry to buff up livestock, antibiotic resistance is promoted.

The tendency to indiscriminately prescribe antibiotics, especially by its poorly regulated private healthcare sector, has meant that India is identified as a country with growing antibiotic resistance. Public misinformation on the proper use of antibiotics is also an issue — for instance, a 2011 WHO study showed that 53 per cent of Indians were taking antibiotics without a doctor’s prescription. But this is far from an Indian problem, as the WHO report found. Among the WHO’s concerns is a lack of incentive for pharmaceutical companies to develop a strain of drugs that are to be used briefly and sparingly, although tackling resistance will require a new stream of antibiotics. Compounding this is the absence of a standardised way to assess and share information on drug-resistant infections. Increasing global coordination and treating antibiotics as a public good are a must to grappling with the spectre of going back to the past in public healthcare.

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