The Coming Antibiotic-Resistance Pandemic that Could Make COVID Look Like the Flu

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from MintPress News:

GENEVA — Big pharmaceutical companies have not come out of COVID-19 looking like model global citizens. Pfizer has been accused of bullying South American governments after demanding they put up military bases as collateral in exchange for vaccines. Meanwhile, Bill Gates persuaded Oxford University to sign an exclusive deal with AstraZeneca for its new offering, rather than allow it to be copied freely by all. The British/Swedish multinational quickly announced it would fall 50 million vaccines short on its first shipment to the European Union.

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But what if there were a looming health crisis that could make COVID look almost minor in comparison? The World Health Organization (WHO) has been warning of just such a case for some time now, predicting that antimicrobial resistance will kill up to 10 million people every year by 2050 — almost four times as many as the coronavirus has killed in the past 12 months.

“Antibiotic resistance is one of the biggest threats to global health, food security, and development today,” they write, noting that without effective antibiotics all manner of conditions — including pneumonia, tuberculosis, gonorrhea, and salmonellosis — could become far more deadly. Drug companies are making this situation worse by encouraging the overuse of our precious stores of antibiotics, particularly in the Global South and also by refusing to invest enough resources into creating new ones.

 

Global overuse

The more antibiotics are used, the more resistant bacteria become to them, meaning that humanity must guard its reserves and slow down the pathogens’ adaptive evolution by using them only when necessary. Between 2000 and 2015, antibiotic consumption decreased by 4% in rich nations but increased by 77% in developing ones, and their overuse has become rampant across the world. The poorer enforcement of medical laws in these countries leads manufacturers to “adopt unethical marketing approaches and develop creative ways to incentivize prescribing among healthcare providers,” in the words of Dr. Giorgia Sulis, an infectious disease physician and epidemiologist at McGill University, Quebec.

As Sulis explained to MintPress:

India is perhaps the best example in this regard, due to its large pharmaceutical market and the predominant role of the private sector in healthcare delivery. A private sector that is highly fragmented and largely unregulated, where a substantial proportion of providers lack any sort of formal medical training, is extremely vulnerable to [these kinds] of bad business strategies.”

Superbugs already kill an estimated 58,000 babies inside the country each year.

While India does have a national healthcare system, it is chronically understaffed and underequipped, leaving most of the population to rely on one of the millions of informal providers — health workers who have no official qualifications. Informal providers vastly outnumber trained professionals.

“There is a very haphazardly integrated type of medicine, which is practiced all over India. We have a professionalized modern healthcare system with regulations. But it is a system that is limited” in its size and scope, explained the London School of Hygiene and Tropical Medicine’s Meenakshi Gautham, an expert on antibiotic use in South Asia. “Informal providers or para-health workers are the ones who continue to meet the healthcare needs of millions of people who don’t have access to the formal health system.”

India Antibiotics

A man sorts through a bag of expired and partially used medication in New Delhi. Saurabh Das | AP

These informal providers are a goldmine of profits for big pharma. A 2019 study by the Bureau of Investigative Journalism found that a host of drug companies ply them with cash incentives, gift cards, medical equipment, vacations, televisions, free samples, and discounts on bulk purchases — all of which were intended to increase antibiotic use, thereby risking overprescription. Some salesmen admitted to undercover reporters that they knew the drugs were being misused, but that they were motivated purely by profit. They also revealed that they would promote drugs to informal providers based on their profitability, not their efficacy.

These informal workers are commonly written off derisively as “quacks” who give out treatments mindlessly. While Dr. Gautham’s work found that they often do have major holes in their medical understanding, she defended them as a vital part of a healthcare system under which seeing a qualified doctor is beyond the financial means of millions. “You might assume that they are illiterate and they are quacks and they do not know what they are doing but that is not true. What we found was that about 30% may even be graduates or postgraduates,” she said, adding that most had worked as doctors’ assistants and continued to be mentored by them.

Informal practitioners are usually respected and important members of their communities and, when in doubt, often consult qualified doctors on the best course of action. Dr. Gautham’s study also found that they did not prescribe any “reserve” antibiotics — powerful medications considered a last resort and therefore used in hospitals as sparingly as possible.

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