Antibiotics will soon stop working, scientists warn
Doctors and scientists are warning we might have only a few years left to use antibiotics, before pathogens like gonorrhoea, tuberculosis and E. coli become untreatable.
"A future without antimicrobials will affect us all; rich and poor, young and old," says University of Auckland microbiologist Siouxsie Wiles.
"In a world without antimicrobials, previously treatable infections will once again become deadly, or may require amputation to stop them in their tracks."
Deadly microbes, particularly bacteria, are becoming increasingly resistant to modern medicine. It's largely down to overuse - we're using antibiotics for things like colds and headaches, when we shouldn't be.
"Antivirals don't work on bacteria, and antibiotics don't work on viruses," says Dr Wiles.
Bacteria reproduce incredibly rapidly - into the billions in less than a day - and like any living creature, each time they reproduce there's a chance of mutation. Some of these mutations make them resistant to medicine that would normally kill them.
When antibiotics are used, only the resistant bacteria survive and then reproduce rapidly. Before you know it, the resistant form of the bacteria is dominant and medicine stops working.
It gets worse - some bacteria can pass on resistant genes simply through touch.
"They don't even need to be in the presence of the antimicrobial agent - they just need to meet the right kind of resistant microbe," says Dr Wiles.
"The situation is a catastrophe on a par with global warming."
It's a little-known fact that while the first lab-developed antibiotics were made available to the public in the 1940s, no new types of antibiotics have been approved for public use since the 1980s.
"Most of the pharmaceutical industry pulled out of antimicrobial research decades ago, so the medicine cupboard is basically empty," says Dr Wiles.
"The vast majority of government and charity funding around the world has gone on researching non-communicable diseases."
The World Health Organisation warned in 2014 that Earth was about to enter the "post-antibiotic era", but the message doesn't appear to be getting through to Kiwis. Between 2006 and 2014 antibiotic use rose 49 percent, according to Ministry of Health figures. The increase was across the board - all age groups and ethnicities, both sexes and every district health board.
"Because antimicrobials are also used to prevent infection in vulnerable people, it will also become life-threateningly risky to do routine operations like caesarean sections and joint replacements, and treatments like chemotherapy for cancer," says Dr Wiles.
Resistance is still low in New Zealand, but that's changing fast. We use more antibiotics on average than more than two-thirds of the countries in Europe, and we're increasingly trading with countries in southeast Asia, where resistant forms of E. coli, pneumonia and tuberculosis are prevalent.
"New types of antimicrobial resistance... usually emerge in overseas countries where controls on the use of antibiotics are far less stringent than here in New Zealand," says Lynne St.Clair-Chapman of the Institute of Environmental Science and Research.
There is some hope on the horizon. Last year scientists found the first new antibiotic since 1987, called teixobactin. It has a different way of killing bacteria than older antibiotics - it stops them from building their cell walls.
"That's what we're looking for," says Dr Wiles. "Anything that has an old [method of killing], there will be a way for the bacteria to resist it."
But it's not effective against every kind of bacteria, and is yet to be fully tested in the lab.
"Any new antimicrobial compound discovered today could take a decade of development and testing before it would be available for doctors to use," says Dr Wiles.
Early studies have suggested bacteria are unable to develop resistance to teixobactin. It's a promising start, but Dr Wiles is sceptical.
"With microbes, you can never say never. This is what they do."
And even if it follows through on its early promise, teixobactin on its own won't solve the problem.
"Teixobactin is one medicine - what we need is 100 or 1000," says Dr Wiles.
Prof Kurt Krause of the Webster Centre for Infectious Diseases at the University of Otago says there are five things we need to do to slow down the spread of resistance enough to give scientists time to develop new treatments.
The University of Auckland has teamed up with data charity figure.nz, and will be posting regularly about bacterial and health issues on the Te Pūnaha Matatini website this week, and on social media under the #infectednz hashtag.