The WHO has been raising the ‘threat level’ on this issue progressively each year for the last decade, with individual disease reports highlighting the emerging threat of antimicrobial resistance (AMR). This year’s report however highlights this pandemic like never before, demonstrating it’s global nature and its profound impact on health and economics. I’m a cardiologist and the report speaks to me – actually it screams out loud: “We need to get our act together”.
As we near the 100-year celebration since the introduction of penicillin, do we really have cause to celebrate? Have penicillins and their advanced brother cephalosporin been conquered? These are among the grave questions asked by the WHO’s first global report on antibiotic resistance released May 2014. The report paints an accurate and grim picture of the state of affairs worldwide. I’ve trained and worked in Bombay, Brooklyn, Boston and the Big Apple. I’ve had the misfortune of seeing the saga of antimicrobial resistance to tuberculosis, malaria, HIV, influenza, pneumonia (Strep. And Klebsiella), urinary infections (E.Coli), MRSA and gonococcal infections unfold in the last two decades through my journey in medicine. I may even be guilty of contributing to it as a patient-pleasing physician and a father of three kids.
“How did we get to the age of antibiotic resistance? Where did we go wrong? What is being done to ensure this gets resolved and these situations don’t arise again?” Profound and simple questions, which tie the glorious history, the current nadir and the hopeful future of antimicrobials together.
Without spending time lamenting what are bygones, let me focus on the way forward. The first positive thing is that much like other areas of medicine, AMR has led to collaborative teamwork among physicians, scientists and the medtech industry. This is the only way for innovative solutions to difficult problems. Secondly, the medtech industry has charted its path with reasonable clarity (See Company View and Industry View blogs) and is pursuing it with a single-minded zeal and passion. Thirdly, federal (British Prime minister Cameron’s statement in Schulze’s blog, CARE – China Against Resistance- an agreement between the Chinese public health authorities and bioMerieux) and private funding (Foundation View) is being channeled to fuel the growth of disruptive solutions as DNA –based technologies (IRIDICA, Abbott), novel biomarkers (VIDAS BRAHMS PCT), molecular panels (BioFire Film Array), mass spectoroscopy based solutions (VITEK MS), and improved clinical informatics (Myla).
The physician community has to realise that we need to play a critical partnership in raising awareness of this resistance and translating that awareness into our prescription patterns. Let me conclude with the physician’s bare perspective for our medtech friends – give us diagnostic solutions that are accurate, easy, fast and affordable – and – in that order. We will take the baton from there!
-Sameer Bansilal, Attending Physician, Mount Sinai Cardiovascular Institute, New York
Editor’s Note: This post is part 4 of a 4-part series on Superbugs. It gives a Physician View on the Superbugs discussion. Check out the Company View, Foundation View and Industry View in the Superbug series.