I’ve been writing about this subject off an on for decades. If you think the death, disease, and panic over COVID-19 has been something, wait until there’s a major outbreak of a drug-resistant “superbug” which is inevitable. Here’s a report by Kevin Outterson at STAT:
Failing to plan, it’s been said, is planning to fail. By this standard, the United States and other countries are planning for failure when it comes to preparing for the next public health crises, one of which will certainly be antimicrobial resistance, the phenomenon in which bacteria and fungi evolve to resist even the strongest treatments.
Covid-19 has demonstrated the catastrophic result of a virus catching the world unprepared. But over human history, bacteria have been our most dangerous foe. So it doesn’t make sense to me that the Biden administration recently released a pandemic preparedness plan that mentions the threat of antimicrobial resistance just once, and then only in passing.
This omission is ominous. Drug-resistant “superbugs” sicken nearly 3 million Americans each year and kill 35,000. Some experts estimate the real toll is much higher, with up to 162,000 Americans dying each year from antimicrobial resistance. An influential report commissioned by the Prime Minister of the United Kingdom and the Wellcome Trust estimated this scourge could kill as many as 10 million people each year around the globe.
While I agree that such a catastrophic eventuality is inevitable, there are things that can be done to minimize it and/or postpone it. The first thing is to reduce the profligate use of antibiotics both here and abroad. Countries in which antibiotics are available over-the-counter are commonplace whether de jure or de facto. In India antibiotics for human use are available over-the-counter without a prescription. In China and Indonesia in theory a prescription is required but in practice they are widely available over the counter. That accounts for a third of the world’s population right there.
Closer to home while in theory antibiotics for human consumption in Mexico require a prescription, in practice they are still readily available over-the-counter. Here in the U. S. antibiotics for use by animals, particularly farm animals, are available over-the-counter and that has risks all its own. Not only should we be tightening up on restrictions here, we should be providing incentives for other countries to tighten their own restrictions not just in theory but in practice and restrict travel to countries that don’t do so.