Who could have believed when antibiotics were being pioneered less than 100 years ago that antimicrobial resistance to these ‘miracle’ cures would today be described as one of the biggest threats to global health?
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That if superbugs continue to outflank antibiotics because they are being over-prescribed for people and livestock and losing their effectiveness, it could, according to the chief medical officer for England, lead to “the end of modern medicine”.
Someone back then had an accurate vision of the dangers to come and that was the man who started it all: Sir Alexander Fleming, discoverer of the first true antibiotic, penicillin, in 1928. Recently, I had the pleasure of meeting a distinguished physician who heard Fleming sound the warning.
A wealth of experience
At the age of 106, Bill Frankland is Britain’s oldest doctor and, I’m glad to report, in amazingly good health and spirits. As a medical student in 1936 he attended a lecture given by the great bacteriologist some years before penicillin was on the market. “Fleming said that when it was readily and cheaply available and you can take it not just by injection but by mouth it will be used for all sorts of infections and it will be overused,” Dr Frankland told me. “I always remember that he added that bacteria are very cunning little things and they have to survive. There will be resistant forms and in the end, this marvellous antibiotic, being overused, will become almost useless. I thought at the time this was stupid, it surely wouldn’t happen, but he was right.”
Dr Frankland went on to work with Fleming and later became a world expert on allergies and the treatment of asthma. During his work on hay fever he was responsible for the pollen count becoming part of everyday life in the UK each spring and summer.
Bill Frankland came to share Fleming’s concern of antibiotics losing their power. That concern is now echoed by health professionals around the world, with superbugs such as MRSA and e-coli bloodstream infection bringing a new, deadly dimension to medical care. If more action isn’t taken to control them, many routine hospital operations will not be possible and worldwide, 10 million people a year are predicted to die from drug-resistant infections by the middle of the century. Last year, the Government announced a £30 million investment in antimicrobial resistance studies.
Adding to the fears is the very real threat of antimicrobial resistance being passed to us through the food chain, because in many countries antibiotics are being overused as growth promoters and fed to perfectly healthy animals. In China and the USA, for example, the vast majority of antibiotics are given to animals, not people. Recently, the EU voted to bring in laws banning farmers from getting access to antibiotics that are used in human medicine. Whether the UK follows suit remains to be seen.
Fortunately, Dr Frankland has been hale and hearty during his long life, despite experiencing the horrors of a Japanese prisoner-of-war camp. A few weeks ago, I watched him happily signing copies of his new biography, From Hell Island to Hay Fever by Paul Watkins.
Had anyone asked him what Fleming’s response would be to the menace of superbugs, he would have said: “Told you so!”.