Antibiotics: is David Cameron about to save the world?

Scientists are not known for over-exaggerating (unlike, ahem, journalists).

So when the UK’s chief medical officer warns that the era of modern medicine will come to an end unless action is taken on antibiotic drugs, posing what she describes as a “catastrophic threat”, it is worth paying attention.

Professor Dame Sally Davies’ warning comes after a similarly apocalyptic report from the World Health Organisation in May.

“Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” said Dr Keiji Fukuda, Who’s assistant director general for health security. “The implications will be devastating.”

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And now Prime Minister David Cameron is getting in on the act.

Announcing a new initiative to look at how pharmaceutical companies can be encouraged into making new antibiotics, Mr Cameron said: “If we fail to act, we are looking at an almost unthinkable scenario where antibiotics will no longer work and we are cast back into the dark ages of medicine.”

Of course, politicians are not known for holding back on the rhetoric either – but this time there is something different. After months and years of pleas from doctors and scientists on antibiotics and superbugs, it seems like action may be about to be taken.

Time to walk the walk

Laura Piddock, professor of microbiology at the University of Birmingham and chair of Antibiotic Action, told Channel 4 News: “The main concern is we keep talking and talking – but we have to start implementing the recommendations made by doctors and scientists.”

The initiative is the latest sign that politicians and the public are waking up to this.

Last month the public voted for the £10m Longitude Prize, which aims to find, fund and create world-changing solutions to major problems, to focus on tackling the rise of antibiotic resistance.

Antibiotics are effectively victims of their own success. Cheap and effective, humanity sprinkled them round to kill off infection in everything from bacterial bugs to helping patients recover after operations. We even gave them to animals in the food chain, to keep them healthy.

If we fail to act, we are looking at an almost unthinkable scenario where… we are cast back into the dark ages of medicine. David Cameron

But right from the moment Alexander Fleming invented penicillin, back in 1928, he warned that bacteria would grow resistant. He was right. Natural penicillins were quickly defeated. Synthetic penicillins lasted a bit longer. The third generation, carbapenems, were further modified, but in 2003 even they began to fail for some microbes in the UK.

In part to try and deal with the growing threat of drug-resistant microbes, doctors stopped prescribing them. But this slightly backfired: knowing this, pharmaceutical companies realised they wouldn’t make any money developing new antibiotics. So they stopped. No new classes of antibiotics have been developed for more than 25 years and now growing numbers of people are dying as a result.

The European Centre for Disease Prevention and Control estimates that antimicrobial resistance results in 25,000 deaths a year.

Professor Piddock described it as “market failure”. And the problems if it is not solved are huge.

Saving the world

“In the pre-antibiotics era, people died from common infections,” said Professor Piddock. “But they weren’t even having things like transplants, hip operations. Our medicine is now very sophisticated so it will have a huge impact in both high and low income countries.”

Mr Cameron’s initiative will see former Goldman Sachs chief economist Jim O’Neill lead an international expert group focusing on the development of antibiotics and the regulatory conditions around the drugs, fixing the “market failure”, the rise of drug-resistant strains, and the over-use of antibiotics globally. The Wellcome Trust has pledged the initial £500,000 cost of the work.

So at the same time as making sure antibiotics are only prescribed sparingly and when needed, the group will also look at how to stimulate the market in developing new antibiotics – an attempt to tackle both sides of the problem at once.

So is this the golden bullet? The solution? Reason to put our tin cans back in the cupboard and come back down off the remotest hills? In short: is David Cameron about to save the world?

“We are saving the world,” said Professor Piddock firmly. “He can’t do it alone. He’s only acting because we’ve told him action has to be taken. We are all involved in causing this problem, and we are all involved in solving it.”