At the risk of provoking more pig-headed defense of capitalist medicine
again on this list, I offer yet one more article about 'The Bugs'.
It's not an issue that's going to disappear, as it is one of the key
elements of the crisis in ecololgy that capitalism has brought about to
our planet. It is of the magnitude of problem similar to that of
global warming and the extermination of multiple species.
Tony Abdo
-------------------------------------------
Microbes Winning War
By Marc Kaufman
Washington Post Staff Writer
Tuesday, June 13, 2000; Page A01
Microbes that cause diseases ranging from sore throats and pneumonia to
malaria and AIDS are mutating at an alarming rate around the globe into
much more dangerous infections that fail to respond to drugs, the World
Health Organization warned yesterday.
If the current pattern continues, the world could be plunged back into
the "preantibiotic era" when people commonly died from diseases that in
modern times have been easily treated with antibiotics and other drugs,
the WHO concluded in its first major report on the issue.
"The world may only have a decade or two to make optimal use of many of
the medicines presently available to stop infectious diseases," said
David Heymann, executive director of the WHO's communicable disease
program.
"We are literally in a race against time to bring levels of infectious
disease down worldwide, before the disease wears the drugs down first."
Drug resistance is spreading mainly due to overuse of antibiotics in
wealthy nations, incomplete and under-use of medications (and especially
"counterfeit" drugs) in poor nations, and the widespread practice of
feeding livestock low levels of antibiotics to promote growth, the
report concluded.
The WHO called on doctors in developed nations to sharply reduce their
prescribing of antibiotics, which the agency estimates are necessary
only half of the times they are used. It also recommended a major
international effort to bring more anti-infection medications to poor
nations.
Public health experts around the world have been concerned about the
rise of resistant microbes for years. The report from the WHO, an
affiliate of the United Nations based in Geneva, is the most
comprehensive--and perhaps the most alarming--account to date.
The ability of bacteria, viruses and parasites to become resistant to
drugs is a naturally occurring phenomenon involving mutation and
survival of the fittest microbes. It becomes a problem only when
disease-causing organisms develop the ability to fight off otherwise
disease-curing drugs. These resistant organisms develop and grow
stronger when medications are only partially used (as with antibiotics
in the poorer nations) and when they are used even when they are not
needed (as in the United States).
Because the pharmaceutical industry developed so many effective
antibiotics in the post-World War II era, many believed the need for
more had declined and most drug companies lost interest in researching
more. As a result, Heymann said, "Currently, there are no new drugs or
vaccines ready to quickly emerge from the research and development
pipeline."
The WHO report described numerous examples of serious health
consequences of drug resistance, including:
* In the United States, an estimated 14,000 people die each year from
drug-resistant microbes that infect them in hospitals.
* A decade ago in India, typhoid could be
cured with the use of three inexpensive drugs. Today, those drugs are
largely ineffective against the life-threatening disease.
* In Eastern Europe and parts of Russia, more than 10 percent of
tuberculosis patients have strains resistant to the two most powerful
antibiotics.
* In much of Southeast Asia, 98 percent of gonorrhea strains are
resistant to penicillin--which had been the first-line treatment for
decades.
Jeffrey Koplan, director of the U.S. Centers for Disease Control and
Prevention, was also present today to unveil the WHO report, and he said
the WHO and CDC "are at one on this issue."
He also voiced more optimism, however, that drug companies will be able
to produce effective new antibiotics soon, and that antibiotic usage
rates in the United States can be reduced. After an intensive campaign
to limit antibiotic use in Canada several years ago, prescribing rates
dropped dramatically.
The president-elect of the American Medical Association, Randolph D.
Smoak Jr., said yesterday that he supported the WHO conclusions, and
that his organization will be formally considering guidelines later this
week encouraging doctors to better educate their patients and themselves
about the dangers of antimicrobial resistance.
But he also said the problem of antibiotic overuse in particular will be
difficult to solve. "When physicians are pushed and pressed to see
patients more rapidly, it's a great temptation to just write an
antibiotic prescription rather than to spend five minutes explaining to
that mother why not it might be better in the long term not to prescribe
it," he said.
The WHO also recommended that antibiotics used to treat humans not be
fed as growth promoters for animals. The European Union already has
banned the animal use of several antibiotics, but the U.S. Food and Drug
Administration has proposed a more limited program of heightening
surveillance and testing of antibiotic resistance in animals. The agency
has been under pressure from livestock and pharmaceutical companies not
to tighten animal drug restrictions.
The House International Affairs Committee announced yesterday that it
would hold a hearing on June 29 to examine the threat to American
security and health posed by infectious diseases.
"The world is a smaller place and no country, including the United
States, is safe from diseases which are able to traverse the globe in a
matter of week," said committee member Rep. Sam Gejdenson (D-Conn.).
© 2000 The Washington Post Company
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