Antibiotic resistance is one of the major health challenges of the 21st century. And the time has passed to stop the dire effects.
The rise of multi-resistant bacteria has already led to a significant increase in diseases and deaths in humans. The US Centers for Disease Control and Prevention estimate that approximately 2.8 million people are infected with antibiotic-resistant bacteria worldwide, causing 35,000 deaths in the US each year and 700,000 dead worldwide.
A Joint report 2019 The United Nations, World Health Organization and World Organization for Animal Health say drug-resistant diseases could cause 10 million deaths each year by 2050 and drive up to 24 million people into extreme poverty by 2030 if nothing is done. Superbugs can already avoid all existing treatments – a 70-year-old Nevada woman died in 2016 of a bacterial infection resistant to any antibiotic available in the US
I am a Biochemist and microbiologist who has been researching and teaching on antibiotic development and resistance for 20 years. I believe that solving this crisis will require more than just the correct use of antibiotics by doctors and patients. It also requires mutual investment and collaboration between industries and government.
Antibiotics have revolutionized modern medicine. But the improper use of antibiotics and the lack of research funding have created a growing crisis of antibiotic-resistant bacteria.
How do bacteria become resistant to drugs?
In order to survive, bacteria of course evolve to become resistant to the drugs that kill them. They do this through two methods: genetic mutation and horizontal gene transfer.
Genetic mutation occurs when the DNA or genetic material of the bacteria changes randomly. If these changes allow the bacteria to evade an antibiotic that would otherwise have killed them, they can survive and pass this resistance on as they reproduce. Over time, the proportion of resistant bacteria increases as non-resistant bacteria are killed by the antibiotic. At some point the drug will no longer work on these bacteria because they all have the mutation to resistance.
The other method that bacteria use is horizontal gene transfer. A bacterium acquires resistance genes from another source, either through its environment or directly from another bacterium or bacterial virus.
Bacteria can acquire resistance through infection with a virus (transduction), ingestion from the environment (transformation) or direct transmission from other bacteria (conjugation).
But the antibiotic resistance crisis is broad anthropogenic or man-made. Factors include the overuse and abuse of antibiotics, as well as the lack of regulation and enforcement of proper application. For example, doctors prescribe antibiotics for non-bacterial infections and patients who have their prescribed course of treatment Giving bacteria the chance to develop resistance.
There are also no regulations too Use of antibiotics in animal husbandryincluding checking for leaks into the environment. Just recently Has there been a push for more antibiotic supervision in agriculture in the US? connects the health of humans, the environment and animals. In order to effectively address one facet, the other must be addressed.
The discovery of the antibiotic is empty
One of the main reasons for the resistance crisis is the stagnation in antibiotic development over the past 34 years. Scientists call this that Antibiotic discovery invalid.
In 1987, researchers discovered the last class of highly potent antibiotics. No new antibiotics have made it out of the lab since then. That’s partly because it was there no financial incentive for the pharmaceutical industry to invest in further research and development. Antibiotics were also effective in what they were doing back then. Unlike chronic diseases like high blood pressure and diabetes, bacterial infections typically don’t require ongoing treatment and therefore have a lower return on investment.
Reversing this trend requires investing not only in drug development, but also in basic research that will enable scientists to understand how antibiotics and bacteria work in the first place.
Basic research focuses on developing knowledge rather than developing interventions to solve a particular problem. It gives scientists the opportunity to ask new questions and think long-term about nature. A better understanding of the driving forces behind antibiotic resistance can lead to innovations in drug development and techniques to combat multi-drug resistant bacteria.
The basic science also offers Opportunities to mentor the next generation of researchers tasked with solving problems such as antibiotic resistance. By imparting the basic principles of the natural sciences, basic scientists can train and inspire future employees with passion, talent and competence to tackle problems whose solution requires scientific understanding.
Cooperation through triangulation
Many scientists agree that fighting antibiotic resistance requires more than just responsible use of individuals. The federal government, academia, and pharmaceutical companies must work together to effectively address this crisis – what I call triangulation collaboration.
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The cooperation between basic scientific scientists and pharmaceutical companies is one of the pillars. While basic scientific research provides the knowledge base for the discovery of new drugs, pharmaceutical companies have the infrastructure to manufacture them on a scale that is typically not available in academic settings.
The remaining two pillars include financial and legislative support from the federal government. This includes improving research funding for academics and changing current policies and practices that Hinder rather than offer incentives for investments by pharmaceutical companies in the development of antibiotics.
To this end, a bipartisan bill was tabled in June 2021, the Groundbreaking Antimicrobial Subscriptions To End The Boom Resistance Act (PASTEUR), aims to fill the gap in discovery. If passed, the bill would pay developers contractually agreed amounts to research and develop antimicrobial drugs a period that ranges from five years to the end of the patent.
I believe that passing this bill would be an important step in the right direction to combat antibiotic resistance and its threat to human health in the US and around the world. A monetary incentive to do basic research on new ways to kill dangerous bacteria seems to me to be the best available option in the world to overcome the antibiotic resistance crisis.
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