Waking up from antibiotics binge, world races against disaster

Antibiotics not only heal infections: They also staunch bleeding after childbirth, help cleanse people living in dirty cities, and protect those who work with animals. 
Or at least that’s what many people in Kabul believe.
Doris Burtscher, an Austrian anthropologist, has studied attitudes towards antibiotics at Kabul’s Ahmad Shah Baba hospital, which is run with the support of Doctors Without Borders (MSF).
The hospital staff knows that the overuse of such medicines leads to the spread of bacteria that are resistant to antibiotics, Burtscher says, but many doctors outside the hospital still give in to patients who demand the medicine.
“It’s very difficult, because they want to satisfy theirpatients,” she says.
All over the world, people hold wrong beliefs about the benefits andrisks of these drugs. Their excessive use over the past decades has brought us to the brink of a post-antibiotic era.
The spread of “antimicrobial resistance”, as experts call the problem, means that simple illnesses could turn into lethal ones, and that medical advances in surgery or chemotherapy could be lost as doctors can no longer stop infections.
“To some extent, this is happening now,” says Elizabeth Tayler, a senior expert on antimicrobial resistance at the World Health Organisation in Geneva.

Sexual diseases becoming resistant
Resistant bugs kill an estimated 25,000 people each year in Europ eand a similar number in the United States, she adds.
For example, intensive care units struggle with this problem, as patients whose immune systems are already weakened catch pneumonia that is caused by hard-to-treat superbugs.
Sexual diseases are becoming more difficult to heal, as bacteria now withstand more and more classes of drugs, especially in the case of gonorrhea.
The medical aid group MSF has sounded the alarm in crisis regions such as Iraq and Syria, where very large shares of patients are resistant to multiple drugs.
People tend to take too many drugs in crisis situations, says Burtscher, who has witnessed it in Afghanistan, Iraq, and in a Palestinian refugee camp in Lebanon.
“It’s soothes them in a way,” she explains. “It gives them comfort.”
It would be a mistake, however, to see war zones as the only breeding grounds for nasty bacteria. Antibiotics can be bought without prescriptions in several southern European countries, she notes, increasing the risk of overuse.
A EU briefing paper showed in November that a certain type of superbug that can cause blood and lung infections is now endemic in Malta, Italy, Greece and Turkey.
The WHO and other organisations have been lobbying governments, hospitals, doctors, pharmacies and patients to adopt simple and effective measures. For example, doctors should routinely ask patients what medications they have been taking, and they should tell them how to avoid washing hands. The WHO has recently issued new guidelines to surgeons, telling them to cut down on unnecessary antibiotics use, and to stop shaving patients before operations, because this can cause small infections.

Global cost of US$3.4 trillion 
Changing attitudes is difficult, even if progress has been made in Western countries, WHO expert Tayler says.
“If there is a chance that there is an infection, no doctor wants to miss an infection” she says, explaining why many medics still handout antibiotics when in doubt.
The WHO has developed an action plan that puts a strong focus on improving sanitation and hygiene around the globe, because no new,  more effective drugs are expected anytime soon.
“Currently, most major pharmaceutical companies have stopped research in this area,” the action plan says. Companies fear that anything they develop will soon become useless as bacteria adapt to the new drugs. 
In September, world leaders at the United Nations in New York therefore issued a statement that called on governments, pharmaceutical companies, research institutions and non-governmental groups to all support the much-needed research efforts.
They also stress that the agricultural industry needs to reduce the use of antibiotics, as resistant germs have been spreading from farms to humans.
Governments have begun to understand that growing resistance is not only a medical problem, but also an economic one.
The World Bank estimated in September that the global economy could stand to lose up to US$3.4 trillion annually by 2030 if death rates and healthcare costs climb and if labour productivity falls because of superbugs.
One the other hand, low- and middle-income countries would only need to invest a total of $9 billion each year to curb antimicrobial (AMR) resistance, the World Bank report said.
The report concludes that AMR containment is a hard-to-resist investment opportunity,” it said.