Tag Archives: antibiotics

The end of medicine

I’d noticed maybe twenty years ago that there was an issue with antibiotics. I’m not a scientist, not working in medicine, and even so, I got the message. Antibiotics were a finite resource. To make them last longer we needed to stop routinely giving them to animals and prescribing them for the slightest ailment. Apparently no one else paid much attention. We have a myth (upheld by the movies) that science will find a magic solution in the nick of time. It hasn’t, and the end of antibiotics is now looming.

Without antibiotics, operations will be far more risky, and things that are currently routine will cease to be so. This may mean a collective shift in how we think about medicine, and for me, it’s flagged up some rather uncomfortable ideas about the current systems. The obvious answer to losing antibiotics is to invest more in preventative medicine. There are plenty of ailments that can be avoided, where small, early interventions reduce the need for bigger ones later on. There are many conditions we know perfectly well can be alleviated or avoided just through lifestyle changes.

But here’s the thing. If someone has a heart attack at fifty, goes on to need a bypass, medicines, later a pacemaker, more drugs, more hospital time, they cost a lot of money. Or to put it another way, a lot of money is made out of them. A fit and healthy person who seldom needs to see a GP, much less anything more involved, does not make money for anyone – or at least, not for drugs companies or medical companies. There are financial benefits, for some, from others being ill. There is a whole industry out there that depends very precisely on other people being ill. Then there are the health insurance companies, and even in countries like the UK where medicine is mostly free at point of access, there is still the option to pay for a faster service, and people turning a profit. The more interested our government gets in introducing market forces into medicine, the more reason there is to have people get sick and need curing, the less reason there is to keep people well in the first place. The logic of the market place simply is not consistent with treating human beings in a compassionate and civilized way.

The flip side of this is that healthy people are more productive, more likely to be employed, more likely to have longer working lives than those who are sick. Someone who dies young won’t draw a pension, of course. And if you have a surfeit of poor people who you can’t keep in gainful employment, and you are only thinking in terms of money, letting them die off might make a lot of sense. It’s all about priority. When money comes first in all judgements, kindness and decency won’t get much of a look in. When the price, the cost, the economic value are the first measures you explore, sick people may generate you more GDP than well ones. I have no idea how the figures stack up, but the results are there to see all too plainly. Far more time and effort goes into cure, than prevention.

In a world without antibiotics, preventative medicine has to make more sense. Precautionary measures and lifestyle changes have to predominate, at least if we’re serious about survival. And if money can’t be reliably made the other way, that could well swing it.

The antibiotics problem isn’t news. It shouldn’t have surprised anyone. It was inevitable, we knew it was coming. Just the same way that we know that we will run out of oil, gas and coal eventually. We know climate change is on the cards too, or at least, most of us do. So are we going to follow the antibiotics model here and pretend there isn’t a problem, or hope a magic fix will come in a timely fashion? There are a lot of things we might just have enough time to do something about, but only if we get off our collective posterior sooner rather than later.

So often the argument for not acting comes down to anticipated costs. We can’t be green, it’ll put our industries at a disadvantage. We can’t clean up, it costs too much. No one seems worried about the figures that might be involved in not acting. What is it going to cost us, longer term, if we don’t tackle the pending oil crisis and the melting of the ice caps?

Of course by then, the odds are someone else will be in government, so why worry? They can deal with it. Or science will magic it away, or if we close our eyes and all sing very loudly, we can pretend none of it is happening. It’s not just fantasy, its suicide.