Why India should be worried about antibiotic resistance threat
With the aim of making humans a multi-planetary species, SpaceX CEO Elon Musk unveiled the design and function specifics of his Mars rocket this September.
Musk, through a Reddit “Ask Me Anything” session, fielded a barrage of questions with a mix of witty, vague and specific responses. The question that he provided a crystal clear answer to, without mincing any words, was the one that science and adventure enthusiasts had been most eagerly waiting for - what would it take to book a seat on SpaceX’s Big Fucking Rocket, code named BFR, to Mars in 2024?
All one needs is to fulfil two criteria, answered Musk. First, one must be a billionaire. It will cost $10 billion to buy oneself a chance to be a part of this historic mission to colonise Mars. Second, one must be prepared to die. Sudden, accidental death will be a strong possibility during any moment of this adventurous ride.
Musk’s first precondition cuts down the eligibility for Mars tourism to exactly 2,043 billionaires on Earth, mostly men above fifty. The second precondition on the other hand, of being willing to die, would have been satisfied by all humans. Why is that, one may ask. Well, the answer has been staring in our faces for much too long now.
The human race is at the juncture of an apocalypse - antibiotic apocalypse - in the words of Dr Sally Davies, England’s chief medical officer. Ready or not, billionaire or not, superbugs can push one into a black hole of prolonged suffering leading to death any moment.
No secret superstars
Our species is facing an onslaught by invisible superstars of evolution. Invisible, not secret. These disease-causing bacteria have outsmarted the strongest of antibiotic cures invented by humans in the last century. By developing protective resistance against their poison, the bacteria have transformed into superbugs, guaranteeing their survival while ringing in doomsday for humans.
Antibiotics, an unprecedented achievement of modern medicine, have been rendered ineffective against superbugs, pulling down the shield of defence against day-to-day infections.
In effect, a setback dragging humans into the past by a 100-odd years, when cesarean childbirth and minor surgeries were considered life-threatening not due to the underlying procedural risk but for the risk of acquiring infections. These are the most basic and routine aspects of modern medicine that one takes for granted in current times.
Given this, one is left with no option, but to be prepared to die due to infections in today’s antibiotic-resistant world, whether acquired through a minor injury or a complex surgery. There is no hope on the horizon until scientists develop a new-generation compound or vaccine to counter drug-resistant infections.
The magnitude of this threat, measured in human lives, is equal to 24 million people pushed into extreme poverty by 2030, and 10 million deaths per year by 2050. Economically speaking, the World Bank predicts it to be a global hit as massive as that of the 2008–2009 financial crisis, resulting in a tragedy more severe and more prolonged than that.
It would cause the annual global GDP to fall by a devastating order by 2050, estimated to be in the range of 1.1 to 3.8 per cent. For low and low-middle income group countries (such as India) lurking under the double whammy of weak public health system and poverty, the threat and the impact will be bigger and more intense.
What’s the plan, world?
Superbugs are the biggest health threat to our civilisation. The United Nations had adopted a political declaration for a collaborative, global response to this threat in September 2016 on 10 fronts outlined by British economist, Jim O’Neill. One year on, O’Neill’s assessment on how countries have progressed on these fronts is lukewarm.
Lord O'Neill analyzes #AMRreview progress' 10 Commandments 1year on. 3 meet expectations 3 less and 3 not sure. #ctaAMR17 #StopSuperbugs. pic.twitter.com/DKAfLshjKf
— Marc Mendelson (@SouthAfricanASP) October 12, 2017
The alarming rate at which the problem is growing across the world warrants immediate and simultaneous action on all fronts to optimise access and use of antibiotics. Both at policy level by governments as well as by the civil society. The cost of inaction will derail economies and destroy lives. It is not a country-specific issue, all are in it together. Having said that, India is in the eye of the storm.
The threat has been looming large since the first case of antibiotic-resistant NDM-1 infection surfaced in 2008. Since then, NDM-1 has spread widely within India, and in several other countries. Multi-drug resistant tuberculosis has been on exponential rise in India. The death of an American woman, who had recently returned to Nevada from India, because of the superbug NDM-1 infections that she contracted in India made big news in January 2017.
What’s the plan, India?
Meanwhile, although after much dilly-dallying, the prevailing danger was finally acknowledged by the Indian government this year.
In April 2017, an inter-ministerial group on the topic congregated and a five-year National Action Plan was released by the health ministry. The document enlists a series of tasks, each with a three-tiered priority tag: short-term (S–less than 1 year), medium-term (M–1-3 years) and long term (L–3-5 years).
The implementation task force for this plan needs maximum support and resources from the government. Dragging one’s feet on this issue will bolster an already large-sized avalanche into an uncontrollable monster. The current standing and preparation of India against this challenge (summarised below) is dangerously inadequate along all dictates of O’Neill.
Policymakers and politicians in India must not take a myopic view on the cost of tackling antibiotic resistance. All money and effort spent to counter this challenge will prove to be a high-yielding development investment for the country.
For the world, it’s a choice between realising humans’ ride into the future to colonise Mars and slipping back into history to the pre-antibiotics era of disease and suffering.