'War on superbugs' an overreaction
Canterbury microbiologist Dr Kelvin Duncan replies to the call from British Prime Minister David Cameron for the UK to lead a "global fightback against antibiotic-resistant superbugs".
In my opinion people should not panic over the call by British Prime Minister David Cameron for a global war on superbugs. His call repeats the warnings given in the early 1950s and regularly thereafter, which usually were not heeded.
Biologists pointed out that the overuse of antibiotics in medicine and agriculture and the common failure to complete a course of treatment of antibiotics would lead to the development of resistance. How many of us have bottles of antibiotics with a few pills left in our medicine cabinets?
The development of so-called superbugs is an illustration of evolution in action. Specifically, it is an example of the Red Queen Hypothesis which describes the evolutionary interaction between a predator and a prey who are locked in a grim evolutionary race to evolve superior predatory mechanisms on the part of the predator, and superior defence mechanisms on the part of the prey.
It may be of interest that studies at the University of Canterbury have done much to advance our knowledge of this evolutionary phenomenon.
The problem lies not only in overuse and truncated treatment duration, but also in the legal restrictions placed on pharmaceutical companies and the narrow research focus taken mainly by the English-speaking world. It takes up to US$1 billion to get a new antibiotic to market, and as admitted to me by both regulators and companies, up to 90% of that goes to lawyers and regulators and not into research and development.
Certainly, we must ensure that new products are safe, but the present situation is highly inhibitory and limiting; only companies with very deep pockets can afford to develop drugs.
The situation is made worse by patent offices denying the patenting of natural products, a stand that has been strongly reinforced by the recent decision of the US Supreme Court in the action taken by The Association for Molecular Pathology v. Myriad Genetics.
This means that few companies will undertake the expensive task of developing and testing natural cures if they cannot obtain patent rights. So the millions of cures available in the natural world will not be used in the fight against superbugs. Your garden, if you have one, has organisms with many hundreds of compounds that are worth investigating for their medicinal properties, a fact that many so-called primitive cultures know.
The US makes an argument that the imposition of Pharmac-type arrangements by many countries inhibits drug discovery and development. They may have a point - we may have a hard choice between cheap drugs and effective drugs.
But people should be reassured that there are solutions. We can practise better primary health care and avoid many situations that otherwise would require the use of antibiotics. We can make operating theatres more aseptic and bug free.
We can develop more microsurgical methods that have far less risk of infection. We can change the law and utilise the wonderful world of nature, as the Russians have done with conspicuous success for generations. And we should broaden our research approach by searching for other antimicrobial agents, again as the Russians have done for generations.
Viruses can be used very effectively against infectious microbes - currently there are two virus- based products undergoing trials. And we can improve our immune system as the wonderful Professor Molly Marples of Otago University suggested many years ago when she said that little boys (and girls) should not wash, or not do so too frequently, and certainly without using strong antibacterial soaps. As she emphasised, having a flourishing natural flora on our skin is a prime defence against infection and invasion. And breast feeding or the use of human milk should be greatly encouraged to enable infants to develop their immune system whilst under the protection of the mother's immunity for the first few months of independent life. Working with nature is far better than against it.
But even if we fail to develop synthetic antibiotic agents that are effective against super bugs the worst that will happen is that longevity may be lessened. We will develop other means of dealing with the problem. Humans are not going to disappear under a savage, all- consuming wave of superbugs. Indeed, superbugs are anything but super. They usually cannot survive in the natural world since in developing their own defences in one direction they have become highly susceptible to attack from their own predators and competitors. Readers can be assured that though the situation is serious and requires action on a broad front, the sky is not going to fall.
Kelvin Duncan, who has been involved in developing Australia's third antibiotic, is a former dean of science at the University of Canterbury.