The Edmond Sun

Opinion

October 21, 2013

U.S. needs to take action against 'nightmare' bacteria

Last spring, Arjun Srinivasan, an associate director of the Centers for Disease Control and Prevention, delivered a presentation to state health officials with some alarming information. Before the year 2000, he said, it was rare to find cases of bacteria resistant to carbapenems, a class of powerful, last-resort antibiotics. But by February 2013 they had been seen in almost every state. Srinivasan also briefed Thomas Frieden, director of the CDC. On March 5, Frieden issued a public warning about "nightmare" bacteria, a family of germs known as CREs. They can kill up to half the patients who get bloodstream infections from them, resist most or all antibiotics and spread resistance to other strains.

Last month, Frieden released a report estimating that at least 2 million Americans get infections each year that are resistant to antibiotics and that at least 23,000 people die as a result. Margaret Chan, director general of the World Health Organization, warned last year: "A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child's scratched knee could once again kill."

The words of Frieden and Chan ought to make our hair stand on end. But my reporting for the documentary "Hunting the Nightmare Bacteria," which is to air Tuesday on PBS's "Frontline," suggests that past warnings about antimicrobial resistance were largely discarded. This is not a threat that causes people to jump out of their chairs. It always seems to be someone else's problem, some other time.

We ought to snap out of our long complacency.

Alexander Fleming warned of resistance to penicillin in his 1945 Nobel Prize lecture. But after World War II, the "wonder drugs" seemed inexhaustible and their powers immensely potent, opening doors to new horizons in medicine. Infection no longer meant certain death. What could go wrong?

The answer came in dozens of reports, books and scientific reports warning that bacteria were developing resistance to antibiotics, in part because of careless overuse. In 1982, Marc Lapp published the book "Germs That Won't Die." A conference held in 1984 at the National Institutes of Health resulted in a study published three years later that noted "the consequence of microbial resistance is without boundaries and the spread of resistance genes has been tracked among countries throughout the world." Stuart B. Levy of Tufts University, a pioneer in researching resistance who had overseen the NIH study, published a book in 1992, "The Antibiotic Paradox: How the Misuse of Antibiotics Destroys Their Curative Powers." The Congressional Office of Technology Assessment weighed in with a massive report in 1995. Since then, there has been a stream of popular books and articles.

If Frieden is right, a public health crisis demands more than a business-as-usual approach in Washington. I found smart people at the CDC, NIH, the Food and Drug Administration and elsewhere all working on the resistance crisis, but it is almost impossible to find anyone at - or near - Cabinet-level who is leading the charge. I am told the main coordinating effort is an interagency task force created in 1999. It meets once a year.

Our indifference can't be chalked up to lack of evidence. Resistance is real.

But politically, there is no active constituency - no patient groups marching in the streets. We take antibiotics for a short period and then forget about them. And hospitals, which can be cauldrons for resistant bacteria, often remain silent about infections and outbreaks out of concern for adverse publicity and patient privacy. Yet another dimension of the crisis is that the economics of drug development have led major pharmaceutical firms to abandon research into new antibiotics while they pursue more lucrative therapies for chronic disease. The antibiotic pipeline is slowly drying up.

President Barack Obama ought to shake us out of this lethargy and appoint someone to tackle antimicrobial resistance across all fronts. The goals are clear: far more detailed, national data reporting; improved stewardship of existing antibiotics; and a major antibiotic drug discovery and development effort. We shouldn't expect government to do it all. This crisis will require truly broad collaboration, including scientists, clinicians, hospitals, regulators and the pharmaceutical industry. But government can light a spark and galvanize people toward a result that each could not achieve acting alone in the face of a real threat.

Antimicrobial resistance is driven by evolution, a relentless process. But we shouldn't throw up our hands. We do not have to return to the pre-antibiotic age. To sustain the wonder in wonder drugs, to find a way forward, a little leadership would go a long way.



 

1
Text Only
Opinion
  • Loosening constraints on campaign donations and spending doesn’t destroy democracy

    Campaign finance reformers are worried about the future. They contend that two Supreme Court rulings — the McCutcheon decision in March and the 2010 Citizens United decision — will magnify inequality in U.S. politics.
    In both cases, the court majority relaxed constraints on how money can be spent on or donated to political campaigns. By allowing more private money to flow to campaigns, the critics maintain, the court has allowed the rich an unfair advantage in shaping political outcomes and made “one dollar, one vote” (in one formulation) the measure of our corrupted democracy.
    This argument misses the mark for at least four reasons.

    April 23, 2014

  • The top 12 government programs ever

    Which federal programs and policies succeed in being cost-effective and targeting those who need them most? These two tests are obvious: After all, why would we spend taxpayers' money on a program that isn't worth what it costs or helps those who do not need help?

    April 23, 2014

  • Free trade on steroids: The threat of the Trans-Pacific Partnership

    Many supporters of the proposed Trans-Pacific Partnership, or TPP, trade agreement are arguing that its fate rests on President Obama’s bilateral talks with Japanese Prime Minister Shinzo Abe in Japan this week. If Japan and the United States can sort out market access issues for agriculture and automobiles, the wisdom goes, this huge deal — in effect, a North American Free Trade Agreement on steroids — can at last be concluded.

    April 22, 2014

  • Can Hillary Clinton rock the cradle and the world?

    What's most interesting to contemplate is the effect becoming a grandmother will have on Hillary's ambition. It's one of life's unfairnesses that a woman's peak career years often coincide with her peak childbearing years.

    April 22, 2014

  • Chicago Tribune: If Walgreen Co. moves its HQ to Europe, blame Washington’s tax failure

    The Walgreen Co. drugstore chain got its start nearly a century ago in downstate Dixon, Ill., before moving its corporate headquarters to Chicago and eventually to north suburban Deerfield, Ill.
    Next stop? Could be Bern, Switzerland.
    A group of shareholders reportedly is pressuring the giant retail chain for a move to the land of cuckoo clocks. The reason: lower taxes. Much lower taxes.
    If Walgreen changes its legal domicile to Switzerland, where it recently acquired a stake in European drugstore chain Alliance Boots, the company could save big bucks on its corporate income-tax bill. The effective U.S. income-tax rate for Walgreen, according to analysts at Swiss Bank UBS: 37 percent. For Alliance Boots: about 20 percent.

    April 21, 2014

  • Sulphur a future major tourist destination?

    Greta Garbo says, “I want to be alone,” in the 1932 film “Grand Hotel.” That MGM film starred Garbo, John and Lionel Barrymore, Wallace Beery and a young actress from Lawton named Joan Crawford. It told the stories of several different people who were staying at an exclusive hotel of that name in Berlin Germany.
    It was critically well received and it inspired more recent films such as “Gosford Park” and television shows such as “Downton Abbey” in that it detailed the relationship between powerful and wealthy people and those who served them. The film opened amidst much fanfare and it received the Oscar for best picture in the year of its release.

    April 21, 2014

  • St. Louis Post-Dispatch: Why poverty across the world matters to Americans

    A child starving in South Sudan should matter to Americans. That was the message delivered last week by Nancy Lindborg, whose job at the U.S. Agency for International Development is to lead a federal bureau spreading democracy and humanitarian assistance across the world.
    That world has reached a critical danger zone, with three high-level crises combining military conflict with humanitarian catastrophes affecting millions of innocents in Syria, the South Sudan and the Central African Republic.
    But back to that child.

    April 18, 2014

  • Government leadership complicit in overfilling prisons

    One of the thorniest problems facing any society is the question of what to do with transgressors. Obviously, the more complicated a culture becomes, the more factors come into play in trying to figure out what to do with those who choose not to “play by the rules.”

    April 18, 2014

  • My best days are ones normal people take for granted

    It is a weekend for working around the house. My fiancee, Erin, and I have the baby’s room to paint and some IKEA furniture to assemble. I roll out of bed early — 10:30 — and get into my wheelchair. Erin is already making coffee in the kitchen.
    “I started the first wall,” she says. “I love that gray.” Erin never bugs me about sleeping late. For a few months after I was injured in the Boston Marathon bombings, I often slept 15 hours a day. The doctors said my body needed to heal. It must still be healing because I hardly ever see 8 a.m. anymore.

    April 18, 2014

  • Instead of mothballing Navy ships, give them to our allies

    A bitter debate has raged in the Pentagon for several months about the wisdom of taking the nuclear aircraft carrier George Washington out of service to save money. The Washington, at 24 years old a relatively young vessel, is due for a costly refit, a routine procedure that all of the 11 large carriers in service undergo regularly.

    April 18, 2014

Poll

Do you agree with a state budget proposal that takes some funds away from road and bridge projects to ramp up education funding by $29.85 million per year until schools are receiving $600 million more a year than they are now? In years in which 1 percent revenue growth does not occur in the general fund, the transfer would not take place.

Agree
Disagree
Undecided
     View Results