Three Scary Charts On The Post-Antibiotic Era

Every year the World Economic Forum surveys 1,000 global experts on the top 50 risks the world faces for its Global Risks report.

This year, they chose to highlight one of the scariest risks out there: the rise of antibiotic resistant bacteria, or what's been called the "post-antibiotic era." A quote from Dr. Margaret Chen, the Director General of the World Health Organization, perfectly sums up the fear:

"A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill."

Seems pretty unlikely, doesn't it? Think again. Despite massive advances in science and health care, we haven't come up with a new class of antibiotics in 25 years.

Some new compounds are in development, but the report cautions that we're "decades behind in comparison with the historical rate at which we have discovered and developed new antibiotics"

There's a business reason for that. Drugs for heart disease and diabetes have much more profit potential, so drug companies focus on those instead of antibiotics.

The more we use a given antibiotic, the bigger advantage we give to those bacteria that are resistant to it. As use increases, resistant bacteria are artificially selected and increase in number over time. We use antibiotics. A lot. Antibiotics are available over the counter in many places.

In the past, this was less of a problem because new antibiotics took the place of old ones. That isn't happening anymore, yet we still feed massive amounts of antibiotics to our livestock, as the chart below shows:

That's just the use for livestock. There's also massive over-prescription of antibiotics for people. Even in developed countries, people don't understand how antibiotics are supposed to be used, or misuse them anyway. The report cites a European study where more than half of French respondents expected an antibiotic for a flu-like disease, which is usually a virus. Doctors scared of malpractice lawsuits sometimes prescribe an imprecise cocktail of whatever's available.

The problem can be even worse in developing nations. From the report:

"In China, for example, drug sales form a significant part of hospitals’ income and, until 2010, physicians’ pay was linked to profits from the sale of prescription drugs. One study found that 98% of patients in a Beijing children’s hospital were given antibiotics for a common cold. Figures from 2009 suggest that 74% of all hospital admissions in China will receive antibiotics to treat their illness or as a preventive measure."

Antibiotics are useless for the common cold. Many places don't have access to a full range of antibiotics, which means that resistant strains grow even faster. Environmental contamination means resistant strains have been found as far as Antarctica.

It's a worldwide problem, which costs $21-35 billion a year in the U.S. alone:

The problem is relatively small today, but it's growing, and the Global Risks report argues that it's realistic to imagine a significant spread of such bacteria, and more dangerous and deadly versions of this bacteria, over the next few years.

Some bacteria have fatality rates of above 50 percent, and are growing resistant to our strongest available antibiotics.

Just as worrisome as the spread and mutation of these bacteria is how ill-prepared we are, given the slow development of new antibiotic classes, and how little we've done to slow overuse.

If something truly deadly breaks out, it's not clear that we'd be prepared.

Dealing with this issue is going to require a multi-pronged approach. One part is the market failure. Waiting until there's a crisis to develop new drugs isn't an option, it takes years, especially if we're hoping to come up with new discoveries instead of just variations on decades-old advances. Governments and other interest parties need to figure out how to incentivize companies to do this research in advance.

On the policy front, countries need to work together to put better health and agricultural policies in place to stop making these bacteria stronger and more prevalent. Diseases don't respect borders.

Find the full report here

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