The rise of the resistant bug

6 Feb 2017

The discovery of penicillin changed the world.  Alexander Fleming revolutionised the way we see microbial infections by discovering the first antibiotic, a feat that ultimately awarded him joint Nobel Prize in Physiology or Medicine with Florey & Chain in 1945. The World Health Organisation estimates antimicrobials, on average, add on 20 years to everyone’s life. Not only do they offer quick relief from that troublesome tooth infection or earache but they also underpin modern medicine as we know it and are crucial for preventing infections after operations and chemotherapy. We couldn’t live without them.

The discovery and introduction of antimicrobials have without a doubt contributed to the decrease in global mortality in the past 70 years. We are winning the fight against infectious diseases. Globally, deaths from malaria have decreased by 60% from 2000-2015. Global DTP3 vaccine coverage rates are reaching 86% of all children in need. The eradication of polio is in our midst.  However, our hard-fought gains are at risk. 

The bugs are fighting back. They are mutating and surviving exposure to the drugs we designed to kill them. We’ve taken these wonder drugs for granted, through unnecessary agriculture use and over-prescription. The development of resistance is nothing new. We have between 2 and 10 million bacteria just between our finger and our elbow, multiplying at fast rates. Evolution tells us that mutations and resulting development of resistance will happen. But with little focus on getting more drugs to our armory, here lies our problem. The drugs don’t work. If we don’t solve the problem now – we risk returning to an age where commonplace infections and operations become impossible to treat and too dangerous to perform.

We’re already getting there. I’m sure you will have heard of hospital-acquired infections such as MRSA (methicillin-resistant Staphylococcus aureus) or multi-resistant E.coli. These infections have a much higher mortality rate than those infected with non-resistant versions and are of real public health concern. However, it is the re-emergence of the “disease of the past” that foretells of the imminent global threat of drug resistant infections – tuberculosis.

As the only airborne drug-resistant infection, tuberculosis is among the most threatening of drug resistant infections to global public health. An estimated 200,000 people died from ‘multi-drug resistant TB’ (MDR-TB) in 2015: one-third of all deaths from AMR.

TB bacteria have certain attributes that make them more likely to develop resistance to antibiotics. The TB bug has an unusually thick, waxy cell wall and the ability to survive in multiple locations in the body making it difficult to treat. It takes months of daily treatment before being eliminated from the body, even with the best drugs available. Partly due to the length and difficulty of TB treatment the bacteria have been able to survive the drugs meant to kill them and become resistant.

Cases of extensively resistant TB, to which even the best treatment we have has only an 11% success rate, are starting to be reported. At the current trajectory, we face a world in which totally drug resistant strains of the disease to which we have no treatment is a very realistic prospect. Without new and better treatments, preventing the further spread of resistant TB, let alone eliminating the disease, will be practically impossible.

Tackling the problem of drug-resistance TB will require truly, global action. Join our campaign now and find out how you can help make possible the development of those new drugs that could save millions of lives now and for generations to come.

 

 

Rachael Crockett

Policy Advocacy Officer (Tuberculosis)

Rachael Crockett is the Policy Advocacy Officer for TB. Rachael is committed to ensuring everyone in the world has access to the life-saving medications they need, regardless of where they live. She leads our policy work on tuberculosis, the Global Fund to Fight AIDS, Tuberculosis and Malaria...

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