Expert warns we need to act now to stop progression of superbugs
Health officials, drug manufacturers and international coalitions are all drawing attention to the growing problem of superbugs -- drug-resistant microbes that are making many modern antibiotics ineffective -- and an expert said there is an opportunity now to stop this problem before it becomes a crisis.
Dr. Matt McCarthy, an infectious disease specialist, assistant professor of medicine at Weill Cornell and staff physician at New York-Presbyterian Hospital, joined us on “Take Care” to discuss his book “Superbugs: The Race to Stop an Epidemic” and the best ways to tackle what has become a global issue.
A recent report by the United Nations warned that, by 2050, in a worst-case scenario, there could be up to 10 million deaths per year around the world if there is not a major effort to combat anti-microbial resistance. In addition, the report said, there are already alarming levels of anti-microbial resistance being seen across all income levels, which means some common diseases are becoming harder to treat.
McCarthy said that numbers like that can seem scary, but it is all a part of drawing attention to what he considers the most important issue in medicine that no one is talking about.
“I don’t want to participate in fearmongering, but the short answer here is that superbugs and drug-resistant pathogens are a vital aspect of public health that has been neglected for far too long,” McCarthy said.
The problem began several decades ago, McCarthy said, shortly after the golden era of antibiotics following the invention of penicillin in the 1950s. The scientific community made what he called a “strategic mistake” by shifting focus to different areas in the 1960s and 1970s because infectious diseases were considered to be under control.
"We are on the verge of a crisis, but we have an opportunity right now to step forward and say, 'We need new drugs.'"
This shift happened just when bacteria were starting to evolve a resistance to the antibiotics that were once used to kill them, McCarthy said, and the problem was not properly recognized until the 1990s, leaving the medical community to play catchup.
Factors that have led to bacterial resistance include inappropriate prescription of antibiotics, improper use of prescription antibiotics and using antibiotics in unnecessary places like gardens and farms.
“All of this leads to the promotion of drug-resistant microbes that, frankly, can kill us,” McCarthy said.
In his book, McCarthy said that the development of new antibiotics has come to a halt just when more drugs are needed. Many doctors are forced to use drugs that are very toxic, but there are not many other options.
This is indicative of the harsh market that exists right now for antibiotics, where doctors are hesitant to prescribe even new antibiotics, which can lead to profit losses for pharmaceutical companies, he said. The result is a disincentive to invest in and produce more and better antibiotics to fight this problem.
“That is a devastating thing for public health because we desperately need new antibiotics, and moving forward, we have to figure out ways to make them as this partnership with big pharma dissolves,” McCarthy said.
McCarthy sees antibiotic development as an important political issue for 2020 and beyond, and he hopes to help his readers to better understand proposals, including creating tax incentives for big pharma to produce antibiotics.
“We have to decide as a society, do we want to negotiate with big pharma to convince them to make these drugs that we so desperately need?” McCarthy said.
In a recent New York Times op-ed, McCarthy wrote that there is a huge shortage of specialists to deal with this as well. As these superbugs are becoming more prominent, doctors are becoming specialized in other areas for the same reason drug companies are not investing in more antibiotics -- it just isn't profitable.
“We pay our infectious disease specialists a woefully pitiful sum,” he said. “They often have to take a pay cut to become specialists in infectious diseases, and that’s an unfortunate reality of modern medicine.”
But all is not lost, McCarthy said. Right now is an inflection point, not an epidemic.
“We are on the verge of a crisis, but we have an opportunity right now to step forward and say ‘We need new drugs. We need new antibiotics,’” McCarthy said. “If we attack this problem now, we’re going to be in great shape for the next 50 years.”
The future of tackling this issue requires action on multiple fronts, McCarthy said. This can include policies like making antibiotics a public good, not something controlled by profit, as well as looking for new antibiotics in nontraditional areas, like the soil.
McCarthy himself is working on clinical trials to solve the superbug problem. He partners up with people that use big data and artificial intelligence to test new antibiotics, he said, and works personally with patients to keep everyone involved better informed.
“I’m trying to get the word out that this is an issue that affects all of us,” McCarthy said.