What about using genetic engineering to breed mosquitos that don’t carry malaria? these could out-compete the bad, disease carriers.
has this been tried?
Better yet, turn them into flying vaccination vectors. Right now they’re disease vectors but you could, in theory, make them work the opposite way. This article is from 2010 but I’ve read something about this very recently so I think this idea has some traction.
There is research using sterile insects, but I think they are still figuring out how to scale it. Really, screening windows and using mosquito nets is very effective, but it’s hard to get people to sleep under mosquito nets (objectively, they are really uncomfortable), and there are logistical challenges to getting nets where they need to be.
I don’t think most Docs are blasé. However I do think that in the US and other educated countries, antibiotics are overused because of the sophistication of the population (see my example for otitis media, above) and in less educated countries, antibiotics are overused because of the unsophistication of the population. Your malaria example is a good one and would occur with or without counterfeit drugs. In less developed areas where malaria is endemic, anti-malarials–when available–are handed out like candy without any confirmatory diagnosis (for resource, not educational, reasons). When I go to undeveloped places as a physician, it’s a constant battle not to hand out antibiotics, period. The population learns real fast not to accept a benign alternative, and learns real fast to make up symptoms that might happen because (where I go) the Hospital Boat only shows up every three months. Different modus operandi on the part of the patient than in the US, but the same result: overuse of any and all antibiotics and an increasing demand to overuse even the expensive ones.
The world is what it is. One can be un-blasé and nevertheless not be convinced there is a very viable solution other than increasingly expensive antibiotics and other approaches. It’s an eternal war, and germs are surprisingly well-constructed to take on modern science. It’s kind of remarkable that we’ve actually defeated a few of them…
I believe in being non-blasé, but I also see most efforts to fix overuse of antibiotics as pretty quixotic.
FDA hopes to curb antibiotic use on farms
FDA takes steps to phase out antibiotics in meat
The World Health Organization has just released a major report supporting this view:
““Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” says Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security.”
Summary at:
http://www.who.int/mediacentre/news/releases/2014/amr-report/en/
Full Report at:
http://www.who.int/iris/bitstream/10665/112642/1/9789241564748_eng.pdf
But probably nothing will be done.
Updating this thread from 2013, six years ago:
So if you start extrapolating 6 years in the future, 12 years in the future, 18 years in the future, 24 years in the future when do your reach a point “Post Antibiotic Infection is the Leading Cause of Death in the U.S”?
Here is the CDC report:
As I understand it, 90% of the true problem is this: the current method of funding drug research doesn’t reward researching new antibiotics. They have a valuable role in saving lives but the very nature of targeting a 1% market (the 1% of patients who all current antibiotics fail on) is there’s no revenue.
So, as I understand it, right now, in the USA, the number of antibiotics being researched at the expensive part of the research - the clinical trials - is zero.
Nada. Zilch. Nothing. That’s the problem. There are thousands of candidate molecules - even whole approaches that are totally new (phages), or rationally designed molecules aimed at known binding sites on specific types of bacteria - and absolutely none are being seriously researched. (where “seriously” means the billion+ dollars of funding required has actually been allocated)
And talking about better agricultural stewardship or some sort of policy to restrict their use is pointless because it just doesn’t matter. If we used half as many antibiotics it still gives a crapton of chances of species to evolve resistance, and if we never develop any new ones, total resistance is a matter of time.
The other thing to consider is the way antibiotics are used. Perfect world:* I see you have an infection. Take this five day course of tablets…*
Five days of sales every several years versus sales every day for the rest of your life for antihypertensives, asthma medication - and so on. There are two ways of looking at this problem - one is pitifully low return on investment; the other is huge prices for a course of antibiotics. They are both a pretty tough sell.
There’s certainly a problem, but a quick google of <antibiotics in development> appears to contradict this. This ref is a couple of years out of date, but I’m choosy about my sources - the BBC is one of the best.
It seems highly improbable that none of this development is in the US. But certainly, nobody is going to argue that everything in the garden is rosy.
j