WHO sounds alarm on antibiotic resistance
The World Health Organization’s (WHO) first-ever list of antibiotic-resistant “priority pathogens”—many of the 12 on the list are already present in India—comes against rather bleak global and national antimicrobial resistance backdrops. Last year, a UK-government commissioned study estimated over 10 million deaths globally from antimicrobial resistance—antibiotic resistance is a part of this spectrum—by 2050. It kills some 700,000 today. What’s worse, given how children’s immune systems are not fully developed, growing antibiotic resistance is likely to exact a significant toll from the young.
Part of the problem is the rampant overuse of antibiotics in the country—while, in 2010, Indians consumed nearly 13 billion antibiotic units compared with Chinese consuming 10 billion and Americans, nearly 7 billion, a 2011 WHO study showed nearly 53% of Indians were consuming antibiotics without prescription. Sales of carbapenems—a last-resort class of antibiotics—had reached 3.8 standard units in 2010, up from 0.15 standard units in 2005. As a result of such overuse—with additional risks from improper calibration of dosage and patients not completing the course—drug resistance has galloped over the last few years.
Though India’s sitting on a ticking bomb, it is not alone. A study by the US Food and Drug Administration report found that 80% of antibiotic usage was in livestock, and this was driving up antimicrobial resistance in humans. A report by the Bureau of Investigative Journalism shows a 40% jump in prescription of colistin by doctors between 2014 and 2015 in the US. Compounding the problem is the fact that the antibiotic pipeline has been near-dry for decades—against the thumb-rule that only one in five antibiotics being tested will receive approval, 19 got the nod in the US in 1984 alone while, between 2010 and 2012, just one was approved.
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The slowdown—only 40 are under development at the moment, with just one antibiotic (representing a new class), teixobactin, discovered in the last three decades—can partially be attributed to the decision of many pharma majors including Pfizer, Eli Lily and Sanofi, shutting down their antibiotic research to focus on the more profitable drug-development for chronic diseases. While pushing antibiotic research and preventing overuse of antibiotics could be key measures to tame growing resistance, a crucial element will be vaccine research and roll-out. India (72%) lags in immunisation rates, compared with a China (99%) or a Brazil (95%). At the same time, there is the need to increase reliance on biotech-driven fight against bacterial pathogens, like the use of bacteriophages (viruses that “eat” bacteria) in morbidity control.