Controlling infections has become increasingly difficult because bacteria are increasingly resistant to the drugs that have been developed to fight them. The White House has been waging a campaign to raise consciousness about antibiotic-resistant bugs for some time, and its latest salvo was launched last week.
Unfortunately, it’s too little and, we hope, not too late.
President Obama described his initiative to improve surveillance of infectious outbreaks, develop better diagnostic tests, boost research into alternative drugs, improve the tracking of antibiotic use and reduce their use.
He also asked Congress to double funding in the war against antibiotic-resistant bacteria.
Since they became widely used last century, antibiotics have become “miracle” drugs that have drastically reduced the number of people who die from infection. But such widespread use – overuse – is precisely why they’re less able to perform miracles now.
Bacteria evolve to develop resistance to their drug predators, so we constantly must develop new ones to combat the old ones’ diminishing power. Some researchers believe that if we can’t get off this treadmill, if we can’t figure out how to halt the trend instead of just staying ahead of it, that the world could return to the time before antibiotics, when people commonly died from ordinary infections.
When Obama initiated the effort last year, the New York Times reported, the medical/health community welcomed the attention it had been seeking for years for the problem of the waning ability to address infectious disease. But many people wish the program had more muscle, particularly against the overuse of antibiotics in agriculture.
The new initiative focuses on moderating the use of antibiotics in humans. It promotes the Centers for Disease Control and Prevention (CDC) as the primary agency to monitor how hospitals and other medical facilities administer antibiotics, and it enumerates steps for hospitals that treat Medicaid and Medicare patients (and therefore receive public funding) to reduce inappropriate use.
“The news here is that the administration is setting specific, annual milestones for tackling the problem,” Allan Coukell told The Times. He’s senior director for health programs at the Pew Charitable Trusts, a research and advocacy outfit that participated in last year’s effort to craft strategy for tackling the problem.
Given our notorious overuse of medical products and services generally, it’s not surprising that Americans use more antibiotics than people in other industrialized nations. According to Pew, we use more than twice as many as Germans and the Dutch.
But you can’t address a problem completely if you don’t have sufficient data, and the White House plan announced last week doesn’t provide it. According to The Times, more than 7 in 10 antibiotics sold in the U.S. goes to livestock, to animals people consume, but producers of meat and poultry are not required to report which antibiotic drugs they use, on which animals and in what quantities.
Scientists note that without that information, it’s difficult to document how routine antibiotic use in animals relates to antibiotic-resistant infections in people.
So although Obama is to be congratulated for finally facing a problem we’ve known about a long time, his approach lacks the total effort required to assess the real power of the enemy. We can, and should, do better.