The Day, Fleming was successful in discovering world's first antibiotic 'Penicillin' through his experiments on fungus, a new chapter was written in the history of mankind. A technique was invented that how a biotic element can be used to resist another biotic element. World of allopathy gradually come to have many therapeutic treatments like anti-bacterial, anti-viral or anti fungal.
The efficacy of antibiotic was such that it became so popular world over that many other local and alternative medicine system got overshadowed. Systems like Homeopathic, Chinese, Ayurveda, Unani (Persian and Indian), Tibetian could not keep pace with advancements in allopathy and anti-biotic research. Antibiotics were preferred for two reasons as they were able to heal the disease quickly and developed on sound scientific principles.
However, this very popularity and efficacy became a limiting factor to ever growing domain of antibiotics. Widespread use, multiple usage of drugs without proper diagnosis of disease, variability or mutation of stain of pathogens, competitive market for health professionals to provide quick relief were among some of the factors that led to development of resistance to antibiotics.
World health organisation in one of its report suggested that if international community did not take proactive measures. This may lead world back to pre-penicillin days. There will be lack of treatment to diseases. Mortality which went down due to such human intervention will further rise and thus, putting the threat of survival to mankind.
It is in this respect that rise in antibiotic resistance is comparable to global warming which also puts the same civilization level threat in the absence of enough safeguards or preventive actions.
Case Study - Resistance to TB
TB has been one of the deadly bacterial disease which became curable only after the discoveries of antibiotics. Scientists discovered anti-TB medicines.
TB treatment requires regular & constant drug administration and negligence in taking even one or two drugs can lead to mutation of TB strain as it gradually develops the resistance against the drug.
Many TB patients initially and even doctors to some extent were not equally attentive through out the entire course. This led to development of resistance to Anti-TB drugs.
It has presently reached the extent when even the last line treatment has failed in curing the disease which is now referred to as MDR - TB or Multi Drug Resistant TB
Resistance to other Drugs
This is not only with TB. But Malaria which is caused due to falciparum is now without any antibiotic to treat it. Similarly, AIDS-HIV drug which was earlier able to prolong the life of patient, is now losing efficacy. Also, anti-cancer drugs face similar problems as that of AIDS-HIV.
This situation is alarming and no where less panicking than global warming. According to renowned journal Lancet, diseases like Malaria and TB are the main reasons behind such high mortality in tropical countries. It adds that soon malaria of all types and TB may again be incurable.
It is interesting coincidence that both global warming and antibiotic resistance will affect tropical areas & their inhabitants significantly. Humid conditions of tropical countries in Africa, South Asia and South East Asia are reason for diseases like AIDS, Dengue, Malaria and Ebola Virus. Moreover, poverty in these countries will further add to the problem as increasing cost of health care will make it inaccessible to them.
Reasons for growing antibiotic resistance
Though, Antibiotic resistance is world wide phenomenon but it is more pronounced in tropical countries. Let us analyse this with Indian conditions.
1. Neem-Haqeem or Quacks (non registered medical practitioners) are believed to be one of the significant reason as they due to their limited knowledge prescribe many antibiotic to treat the same disease which lead to mutation of strain. Recently, a newspaper report put forth the case of Norflox & Metrogyl drugs used to treat diarrhea very effectively but it is no longer the case. Doctors and quacks have moved on to high end 'Zole' ingredient tablets for the treatment of diarrhea.
2. Even MCI certified professionals due to competitive market are in race to provide quick results to patients. They end up prescribing too many antibiotics even for minor disease.
3. Developing countries like India do not have good infrastructure in R&D of new drugs but they focus more on generic markets. This prohibits the availability of better drugs in market. Doctors continue with same old drugs and this, then threatens a situation without drugs to treat disease.
4. Patients in these countries are self made doctors. They visit doctors or health care professionals only as last resort.
5. Practitioners of alternative systems like Homeopathic, Unani, Tibba resort to allopathic treatments to remain competitive in market.
Developed countries also feel threatened due to international migration of people and thus carrying the mutated strain in their countries.
Way Forward
UN report 'Future We Want' which was the outcome of Rio 20+ summit has focused on health & development of human resource. Another Report on "UN Global Sustainable development" presented on the eve of Rio 20+ summit in 2012 has also emphasized that sustainable development is not only in terms of low carbon & efficient economies but also includes health as prime factor in sustainable development.
International community leaders have to come together at multilateral forums like WHO and also civil society organisations like Red Cross Society and Doctors without borders need to join them in this fight which otherwise can perish the mankind itself. Man survived in the pre-antibiotic world period as materialistic advancements in the society were not at the level as today. But situation differs today as pollution, worsening air quality and international mobility has changed in the world and it became impossible today to imagine it without antibiotics or better treatment.
Man's spirit can not be defeated. Therefore, it is time that leaders, scientists take the lead in conducting researches to discover other alternatives and also improve current antibiotic mechanisms and healthcare infrastructure.
Bio technology and Gene Therapy are yet to unravel their potentialities to the world. Nano Tech can further help in fighting several diseases. Constant improvements in antibiotic drugs and new avenues can go long way in fighting this apocalyptic situation.
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