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.
This blog will deal with the social, economic and public policy implications of contemporary science and technology with an emphasis on biomedical aspects.
Thursday, September 19, 2013
Thursday, September 5, 2013
The Global Population Explosion: Can It Be Stopped Before We Self-Destruct?
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
(2) Countdown: Our Last, Best Hope for a Future on Earth? Alan Weisman, Little, Brown 2013. ISBN: 9780316097758
(3) Prosperity Without Growth. Tim Jackson, Earthscan 2011. ISBN 978-184971-323-8
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