The divine law and blood IV:Right and smart.

In the path of the fourth horseman.

Six reasons superbugs will be worse than Aids

Idea for a movie. The year is 2015. We open in a London hospital, where a surgeon (I'm thinking Cara Delevingne) is performing a routine operation. Her hand slips and she pricks her finger on a rib. A week later, she is dead. Meanwhile, her sister (Rachel Weisz?) is giving her fractious toddler some amoxil, but its ear infection just gets worse and worse. Soon the toddler is dead. On the way to the double funeral Rachel Weisz falls in a puddle. Dead. People start to panic. Antibiotics don’t seem to work anymore. East London hipsters look paler than usual, coughing up blood into vintage handkerchiefs: tuberculosis; and Hooray Henrys meet green, agonising ends on the King’s Road: cholera. These diseases have not been seen in Britain in a hundred years! But there’s a modern twist. The clean water in the taps is dangerous. The healthy imported food in the supermarkets is dangerous. People flood into shiny, reassuring 2014 hospitals, but this is a bad mistake. Enter those buildings and you are dead. The hospitals are the worst place to hide.

This state of affairs is closer than you might think. The World Health Organisation has warned that there is an “antibiotics crisis” looming. What they mean is that antibiotics are becoming increasingly useless as resistance to them rises. Soon, we could very well run out of new antibiotics, which means we could start dying of the kinds of infections we learned how to treat 100 years ago.

The World Health Organisation has warned this could be “worse than Aids.” They’re right, it would be much, much worse. Here are six reasons why.

1. There’ll be nowhere to hide. Avoiding HIV/Aids means avoiding unprotected sex and needle swapping. Avoiding superbugs means avoiding falling off your bike, getting a bladder infection, entering a care home, entering a hospital, breaking any bones, catching the flu, diarrhoea, and minor scratches and bruises.

2. In 2012, germs resistant to antibiotics infected 2 million people and HIV infected 2.3 million people. But new HIV infections have been on a 33 per cent decrease since 2001. By contrast, between 2005 and 2012, the World Health Organization found cases of multidrug-resistant tuberculosis in Africa rose by 650 per cent.

3. No one is working on a solution, because the financial motivation for finding new antibiotics just isn’t there. In fact, development of new drugs has slowed hugely. Between 1980 and 1984, the US Food and Drug Administration approved 20 new antibiotics. Between 2005 and 2009 it approved three.

This is because it takes hundreds of millions to develop a new drug, and antibiotics don’t give investors much return. When a doctor prescribes you antibiotics, you only take it for a couple of weeks, so these drugs just can’t compete with drugs for lifelong diseases, such as HIV.

It’s also because people aren’t scared enough yet. They are terrified of Aids. Sepsis: not so much.

Infectious disease expert Brad Spellberg has said:

“We will pay US$50,000 for a course of cancer chemotherapy that prolongs life by 3 months, but we don't want to pay more than $100 for a course of antibiotics that cures the target infection.”

And why? “People are terrified of cancer, but not of infections”.

4. Unlike HIV/Aids, raising awareness about drug resistance could make the situation worse. As experts (correctly) preach the need to use fewer antibiotics, only using them when absolutely necessary, pharmaceutical companies are given less and less motivation to develop new ones.

5. Antibiotic-resistant enzymes can spread through food and through water. Last year 341 tonnes of seafood from Vietnam were found to have antibiotic residue. China’s rivers are increasingly full of drug-resistant enzymes.

6. Drug resistant diseases thrive in the very places set up to treat them. Hospitals bring people together, resistance pre-lowered, and provide them with handy disease carriers, in the form of doctors, nurses, cleaners and the laundry service. This is what experts mean when they say the new superbugs could destroy the infrastructure of the health system. In the event of an antibiotopocolypse, we are screwed.