The CDC report that drug resistant bacteria cause over two million illnesses and result in over twenty thousand deaths per year in the US is very troubling, especially since much of this is preventable. The recent increasing prevalence of carbapenem-resistant enterobacteriaceae (CRE) is truly frightening since the penems are the drugs of last resort in many cases. There are many reasons for the increasing frequency of resistant strains of bacteria, but two of the major contributions could readily be avoided. First, and foremost is the overuse of antibiotics in agriculture. The CDC has traced numerous examples of resistant bacteria to livestock that have been maintained on antibiotics to promote growth. There is increased public awareness of this, accompanied by demand for antibiotic free meats and dairy products. However, the overwhelming proportion of commercial livestock production in this country still relies on antibiotics. A second key contribution is inappropriate use of antibiotics by physicians. Many common illnesses have a viral causation and are thus unaffected by antibiotics. However, many patients demand antibiotic treatment for common respiratory and intestinal diseases even if it is not medically warranted, and physicians tend to acquiesce. More rapid gene-based tests to distinguish viral and bacterial diseases should help to alleviate this problem. In the meantime there is an urgent need for new antibiotics that will kill bugs that have become resistant to older drugs. Unfortunately the pharmaceutical industry is not investing in this area because of the relatively poor profit picture in the antibiotics field.
Thursday, September 5, 2013
Two really interesting books on global population growth were recently published, one by Stephen Emmott (1) and one by Alan Weisman (2). After seeing reviews on line I look forward to reading both of these books. It is about time that someone clearly stated that we need not merely to stabilize global population but to dramatically reduce it in order to prevent total environmental disaster. Unfortunately the trends are not encouraging. The UN has just revised some of its global population predictions upward. Moreover the much-hallowed ‘demographic transition’ whereby increased wealth leads to lower fertility is showing some strain. Thus some very recent data indicates that in China and elsewhere, higher income women are having more rather than fewer offspring. It is hard to see how voluntary measures to spread use of contraception will really impact the enormous momentum of current population trends. The projections for population growth in certain less developed areas such as Africa are truly frightening and will be accompanied by increased consumption, resource depletion and environmental degradation. However, the really sad thing is that the US, which should know better, continues to pursue economic policies that emphasize rapid growth, based partly on an immigration-driven rapid population increase. We need to start thinking about new economic models that do not require constant growth (and constantly increasing environmental destruction) in order to attain a decent life-style for most people. A few economists have started to address this task (3).
(1) 10 Billion. Stephen Emmott, Allen Lane 2013. ISBN: 9780141976327