Persuasive Speech - Taylor Stewart

Antibiotic-resistant microbes infect more than two million Americans and kill over 100,000 each year. These numbers will continue to grow unless we make a drastic effort to curtail them. The necessary response is threefold and includes legislation, awareness, and activism. I will address all of these.

Antibiotics were immensely revered 70 years ago at the advent of penicillin, what started it all. Since 1935, more than 150 antibiotics of various classes have been discovered – each adding to the stability of doctors being able to cure their patients. Physicians saw unprecedented rates of survival for previously almost entirely lethal infections.

This “antibiotic boom” was, to put it lightly, one of the most significant advancements in human history. But there is a slight problem. Unlike virtually all other technological innovations, antibiotics become less effective the more they are used. They are unique in this regard.

Antibiotic resistance is, in simplest terms, just natural selection – but at a hugely exacerbated rate. We can see the effects of natural selection in ourselves; that’s why we don’t have webbed fingers, because they didn’t exactly benefit the terrestrial human race. But while it takes human beings 20-30 years to reproduce, it takes most bacteria 20-30 minutes. Think about that for a second. By reproducing every 20 minutes, a single E. Coli bacterium can create 70 billion new bacteria in just 12 hours. About 2% of those bacteria will have some type of mutation, and .5% (1.5 million bacteria) will have a mutation that enhances their chance of survival. The creation of these unique genes at this incredible rate allows bacteria to adapt quickly to any threatening environment – including those containing antibiotics. The more antibiotics used, the more resistant these bacteria become. As Dr. Brad Spellberg, a prominent figure in the issue, puts it: “the more we use, the faster we lose.”

However scary, it is a natural process. The scary thing is that the process is aggravated by inappropriate use of antibiotics. Around 80% of the antibiotics used in the United States come in the form of consumed livestock – heavily administered by owners to ensure health and encourage rapid growth. Not only does this mass ingestion of antibiotics drastically speed up the development of resistant bacteria, but it also wastes perfectly good medicine that could’ve been used saving human lives.

Another factor that contributes to this extreme rate of resistance development is overperscription by physicians. Now, physicians are not completely to blame here, since patients often demand antibiotics unnecessarily. For example, viral infections cannot, and will never, be cured by antibiotics – yet there’s a surprising incidence of prescription in case of a virus. This also brings up another factor, public ignorance and lack of awareness on the issue. Many people do not understand or are not even aware of this issue, so they don’t exactly ameliorate the problem.

This rapid rate of resistance calls for constant development of new drugs – so the solution seems simple. Just make new antibiotics, you say. Well, there’s your problem – pharmaceutical companies have, for the most part, lost interest in the discovery and development of antibiotics.

As you can see, there has been a steady decline in the development of antimicrobial drugs Due to the extensive amount of research, funding, and regulation required to bring these drugs to market, pharmaceutical companies have become disinterested. Rather, they prefer developing drugs that people use frequently for an extended period of time – so called “lifestyle drugs” (like those used to treat high blood pressure, arthritis, hypertension, something that you take every day for the rest of your life). This lack of development creates a paradox and leaves us asking, “So what do we do?”

Well first I would like to address what we should NOT do. We need to stop the finger pointing. Of those who are actually aware of and concerned about this issue, most have someone to blame for it.

It’s easy to blame pharmaceutical companies – “big pharma,” as they say – for not developing drugs. People believe that “big pharma” has a societal responsibility to develop drugs we need, that they’re “inherently evil” for caring about profits alongside of the general welfare. Others might blame politicians for not making this issue a political priority. It’s also popular to blame physicians for inappropriate prescription of antibiotics.

The fact is, none of these individual groups are entirely responsible for the issue or deserve complete blame. How are we supposed to make any progress if all we do is argue whose fault it is? Lack of antibiotic development is a complex societal problem caused by a mélange of factors – no one group is to blame. Pharmaceutical companies are just being conscientious of their profits and focusing on developing life-prolonging drugs. Politicians are simply answering to their constituents, of whom antibiotic resistance is not a priority And physicians? They’re doing the best they can to keep up in the treatment of increasingly resistant infections.

It is time to stop the finger pointing and converge to find a solution. Now, what is that solution?

There is, of course, a need for legislative action. This includes establishing a federal commission of experts who can draw up a list of priority pathogens – those most threatening and in need of antibiotic development against. The outcome of this, according to the Infectious Diseases Society of America’s (IDSA) 2004 report “Bad Bugs, No Drugs,” would be “the creation of sustainable research and development of infrastructure that respond to current antimicrobial resistance and anticipate evolving resistance. Other than that, the IDSA proposes that we expand upon programs already in place, such as the FDA Orphan Drug Program, established to provide incentives for companies that develop treatments for rare diseases. These incentives, especially direct patent extensions, are somewhat controversial – but a debate is exactly what’s needed, so we can reach a consensus on what to do.

That is what needs to be done nationally. Now, not everyone is a politician, but we all will have a voice in government relatively soon. It’s an issue of public, not political, ignorance – legislative solutions will not be forthcoming until voters are aware of and prioritize this issue. Once it is a societal priority, it will become a political priority.

Other than that, you can make yourself knowledgeable on this issue. We don’t all aspire to be doctors and scientists, but we can all help preserve antibiotics by not asking for them in case of a cold or other viral infection.

The causes of this problem are intricate and multi-faceted, but the solutions are relatively straightforward. As Dr. Spellberg phrased it, “the real barrier to execution of the solutions is a lack of political will, largely due to the lack of public appreciation of the problem.”

It is undeniable that society has grown to take antibiotics for granted. We don’t have experience with the preantibiotic era, our parents don’t, and our grandparents might – but how many of us have tried to talk to grams about the fatality of staphylococcal infections before the development of sulfonamides? Probably not many. The consequences of a continuation of current stagnacity are far more serious than just an increase in untreatable infections. We would be saying goodbye to many hallmarks of modern medical care – the entire reason prolonged or complicated surgeries are possible is antibiotics. Other than that, the consequences are numerous; chemotherapy, organ transplants, even the use of catheters would become extremely limited due to the would-be massive rates of resulting infections.

We cannot allow ourselves and future generations to sink into another “preantibiotic era.” It is pertinent that we stop the blaming, and converge to solve this complex societal problem. And there are so many things we can do; we’re not powerless whatsoever in this. Take it upon yourselves to not be ignorant of the issue, and eventually, make it a priority at the polls – for the lives of millions depend upon what we do at this fork in the road.

                                                                          Works Cited

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