With all the marvels of modern medicine, could humans still die from a paper cut?
For years we’ve taken the ability to fight bacterial infections for granted. After Alexander Fleming discovered the source of penicillin — the world’s first bacteria killer — in 1928, the field of medicine was instantly changed. Diseases that previously filled hospitals suddenly became treatable. Childbirth became safer and surgeries less risky. The result was millions of lives saved, making antibiotics one of the greatest medical advances of all time.
But what if antibiotics stop working?
This is a question that has long troubled scientists. With generations of antibiotic use — and frequently overuse — there has become an ever-growing prevalence of bacterial strains that are multidrug-resistant, or superbugs. Without action, scientists are sounding the alarm that we could enter an era in which many bacterial diseases are completely resistant to any drugs we can offer.
For some people, this has already proved to be a reality.
In 2017, the World Health Organization for the first time declared 12 antibacterial resistant strains as top priorities for pharmaceutical development. Already, more than 2.8 million Americans contract a resistant bacterial strain per year according to the Centers for Disease Control and Prevention. Cases are still rapidly rising, with studies suggesting that deaths worldwide could reach 10 million by 2050 — a fatality rate that equates to roughly double that of the current coronavirus pandemic.
The mechanisms of resistance have been theorized for decades.
Much like how Americans are learning first-hand that viruses can evolve over time, so, too, can bacteria. As antibiotics are prescribed more, the bacteria more readily evades the drugs. Over time, those that are able to withstand the treatments become more prevalent.
In past years, pharmaceutical industries more readily tackled novel antibiotics to overcome this issue. But without market incentives, the pursuit of such drugs as of late has cost companies millions and even pushed some into bankruptcy. The result has been an end to much research and development in the field, with only about 30 to 40 antibacterial compounds remaining in clinical trials. In fact, over the past 40 years, most antibiotics were derived from known chemical structures, with the most recent new class of antibiotics having been developed in the 1980s.
The significant lack of novel therapeutics in the pipeline requires immediate attention.
Seizing on the moment, Colorado’s Sen. Michael Bennet has reintroduced a bipartisan bill called the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance, or PASTEUR Act — a nod to the famed chemist and microbiologist Louis Pasteur.
First introduced in the U.S. House in September 2020, and then in the Senate in June, the bill aims to create market incentives using a subscription model for early-stage antibiotic development targeting the most threatening of microbes. It also seeks to improve use and tracking of antibiotics, a tool to reduce the overall pace of evasion.
The bill is co-sponsored with Sen. Todd Young (R-Indiana) and Reps. Mike Doyle (D-Pennsylvania) and Drew Ferguson (R-Georgia), with wide support from the Colorado BioScience Association, The Pew Charitable Trusts’ Antibiotic Resistance Project, the Infectious Diseases Society of America and countless experts in the field.
For some, the potential price tag of up to $3 billion per contract might seem steep. However, when you consider the economic losses due to pandemics — for example, two economists at Harvard expect the SARS-CoV-2 virus might cost the U.S. upwards of $16 trillion — upfront investments to mitigate superbugs likely pale in comparison to the cost of inaction.
Admittedly, it’s not the flashiest of bills. It’s a practical solution to a practical problem, a style that seems to suit Bennet’s overall demeanor. The only question now is if we’ve finally learned enough the hard way to tackle the problem at hand before it tackles us — if not, that paper cut just might become a lethal infection once again.
Trish Zornio is a scientist, lecturer and writer who has worked at some of the nation’s top universities and hospitals. She’s an avid rock climber and was a 2020 candidate for the U.S. Senate in Colorado.
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