The Rise of the SuperbugWed, 09/06/2017 - 17:12
Antibiotics have saved many lives over the past 70 years but the rise of the “superbug” threatens this. Bacteria is developing resistance to antibiotics, leaving experts scrambling for a new solution
Before antibiotics were accidentally discovered by Sir Alexander Flemming in 1945, an infection of a small cut could kill. For the past 70 years, the discovery of an increasing number of antibiotics has prevented millions of deaths but this is under threat. Resistance or immunity to antibiotics, known as antimicrobial resistance, is emerging and such resistant bacteria are known as “superbugs.”
How superbugs developed is simple to understand. In the words of CDC researcher and superbug expert Maryn McKenna: “Bacteria compete against each other for resources, for food, by manufacturing lethal compounds that they direct against each other. Other bacteria evolve defenses against that chemical attack. When we first made antibiotics, we took those compounds into the lab and made our own versions of them and bacteria responded to our attack the way they always had.”
The Review on Antimicrobial Resistance, funded by the British government, pegs the annual death toll caused by infections no drug can help at 700,000. It estimates that this number will rise to 10 million by 2050 if no action is taken. The WHO estimates that every year 480,000 people are infected with multi-drug resistant tuberculosis. Extensively drug-resistant tuberculosis had been detected in 117 countries by the end of 2015, including Mexico, and it kills 50-70 percent of those infected. The global health body also says that between 2000 and 2015, 49 million lives were saved due to diagnosis and treatment of tuberculosis, which consists of four antibiotics.
The use and prescription of antibiotics for humans is heavily regulated. In Mexico consumers cannot purchase antibiotics without a prescription, which is kept by the issuer. However, the CDC estimates that upto 50 percent of antibiotics prescribed for people and most of those used in animals are unnecessary or not as optimally effective as prescribed. Unfortunately, the CDC also estimates that “1 in 5 resistant infections are caused by germs in food or animals”. “COFEPRIS tightly controls the human consumption of antibiotics but animal meat is the greatest source of antibiotics for humans,” says Felipe Espinosa, CEO of Laboratorios Collins.
In Mexico, tighter regulations that take their cue from other countries could help limit the impact from a contaminated food chain, says Ernesto Algaba, Partner of the Life Sciences Practice at Hogan Lovells BSTL. “[…]Key provisions will need to be amended to provide guarantees products are safe for human consumption. I do not think we have the detailed provisions that may exist in other jurisdictions,” he says, adding that “the regulatory framework needs to take best practices from other jurisdictions into account. We know that in Europe and in the US there are more specific provisions and limitations. Fortunately, products are mainly coming from these jurisdictions into Mexico. Even though we have complex labeling requirements, this is an area that could potentially be improved.”
By 2015, over half of the world’s countries did not have relevant antibiotic legislation. Ensuring food chain security is vital for human health. Over 60 percent of human pathogens are of animal origin and over 20 percent of animal losses are caused by disease. In addition, the OIE reports that five new human diseases are reported every year. For this reason, maintaining animal health is a vital public health issue.
“We also need a more developed legal framework regarding organic products or those free of antibiotics. We need to know if the animal consumed the legal amount of antibiotics or if it is completely drug-free. General regulations in food products need to be connected with organic food and animal antibiotic consumption requirements. Ensuring the quality of meat containing antibiotics and the effects of that meat on humans is vital,” says Cecilia Stahlhut, Senior Associate of the Life Sciences Practice at Hogan Lovells BSTL.
Because bacteria develop resistance so quickly, there is little incentive for pharmaceuticals to search for new antibiotics. McKenna says that a new generation of bacteria develops every 20 minutes, whereas drugs take years to develop. She calls for more incentives for pharmaceuticals to continue the fight.