How can we solve the antibiotic resistance crisis? - Gerry Wright
-
0:07 - 0:12Antibiotics: behind the scenes,
they enable much of modern medicine. -
0:12 - 0:14We use them to cure infectious diseases,
-
0:14 - 0:20but also to safely facilitate everything
from surgery to chemotherapy -
0:20 - 0:22to organ transplants.
-
0:22 - 0:23Without antibiotics,
-
0:23 - 0:28even routine medical procedures
can lead to life-threatening infections. -
0:28 - 0:31And we’re at risk of losing them.
-
0:31 - 0:35Antibiotics are chemicals
that prevent the growth of bacteria. -
0:35 - 0:39Unfortunately, some bacteria
have become resistant -
0:39 - 0:42to all currently available antibiotics.
-
0:42 - 0:46At the same time,
we’ve stopped discovering new ones. -
0:46 - 0:50Still, there’s hope that we can get ahead
of the problem. -
0:50 - 0:53But first, how did we
get into this situation? -
0:53 - 0:57The first widely used antibiotic
was penicillin, -
0:57 - 1:00discovered in 1928 by Alexander Fleming.
-
1:00 - 1:04In his 1945 Nobel Prize
acceptance speech, -
1:04 - 1:09Fleming warned that bacterial resistance
had the potential to ruin -
1:09 - 1:11the miracle of antibiotics.
-
1:11 - 1:14He was right: in the 1940s and 50s,
-
1:14 - 1:18resistant bacteria
already began to appear. -
1:18 - 1:20From then until the 1980s,
-
1:20 - 1:24pharmaceutical companies
countered the problem of resistance -
1:24 - 1:27by discovering many new antibiotics.
-
1:27 - 1:32At first this was a highly successful—
and highly profitable— enterprise. -
1:32 - 1:35Over time, a couple things changed.
-
1:35 - 1:39Newly discovered antibiotics
were often only effective -
1:39 - 1:41for a narrow spectrum of infections,
-
1:41 - 1:45whereas the first ones
had been broadly applicable. -
1:45 - 1:47This isn’t a problem in itself,
-
1:47 - 1:51but it does mean that fewer doses
of these drugs could be sold— -
1:51 - 1:53making them less profitable.
-
1:53 - 1:57In the early days,
antibiotics were heavily overprescribed, -
1:57 - 2:01including for viral infections
they had no effect on. -
2:01 - 2:07Scrutiny around prescriptions increased,
which is good, but also lowered sales. -
2:07 - 2:10At the same time,
companies began to develop more drugs -
2:10 - 2:13that are taken over a patient’s lifetime,
-
2:13 - 2:16like blood pressure
and cholesterol medications, -
2:16 - 2:20and later anti-depressants
and anti-anxiety medications. -
2:20 - 2:25Because they are taken indefinitely,
these drugs more profitable. -
2:25 - 2:31By the mid-1980s, no new chemical classes
of antibiotics were discovered. -
2:31 - 2:35But bacteria continued to acquire
resistance and pass it along -
2:35 - 2:39by sharing genetic information
between individual bacteria -
2:39 - 2:42and even across species.
-
2:42 - 2:46Now bacteria that are resistant
to many antibiotics are common, -
2:46 - 2:52and increasingly some strains
are resistant to all our current drugs. -
2:52 - 2:54So, what can we do about this?
-
2:54 - 2:59We need to control the use
of existing antibiotics, create new ones, -
2:59 - 3:02combat resistance to new
and existing drugs, -
3:02 - 3:06and find new ways to fight
bacterial infections. -
3:06 - 3:10The largest consumer
of antibiotics is agriculture, -
3:10 - 3:13which uses antibiotics not only
to treat infections -
3:13 - 3:16but to promote the growth of food animals.
-
3:16 - 3:19Using large volumes of antibiotics
-
3:19 - 3:22increases the bacteria’s exposure
to the antibiotics -
3:22 - 3:27and therefore their opportunity
to develop resistance. -
3:27 - 3:32Many bacteria that are common in animals,
like salmonella, can also infect humans, -
3:32 - 3:37and drug-resistant versions can pass
to us through the food chain -
3:37 - 3:41and spread through international trade
and travel networks. -
3:41 - 3:44In terms of finding new antibiotics,
-
3:44 - 3:47nature offers the most promising
new compounds. -
3:47 - 3:52Organisms like other microbes and fungi
have evolved over millions of years -
3:52 - 3:55to live in competitive environments—
-
3:55 - 3:58meaning they often contain
antibiotic compounds -
3:58 - 4:02to give them a survival advantage
over certain bacteria. -
4:02 - 4:07We can also package antibiotics
with molecules that inhibit resistance. -
4:07 - 4:12One way bacteria develop resistance
is through proteins of their own -
4:12 - 4:14that degrade the drug.
-
4:14 - 4:18By packaging the antibiotic with molecules
that block the degraders, -
4:18 - 4:21the antibiotic can do its job.
-
4:21 - 4:26Phages, viruses that attack bacteria
but don’t affect humans, -
4:26 - 4:30are one promising new avenue
to combat bacterial infections. -
4:30 - 4:33Developing vaccines for common infections,
meanwhile, -
4:33 - 4:37can help prevent disease
in the first place. -
4:37 - 4:40The biggest challenge to all
these approaches is funding, -
4:40 - 4:44which is woefully inadequate
across the globe. -
4:44 - 4:48Antibiotics are so unprofitable
that many large pharmaceutical companies -
4:48 - 4:51have stopped trying to develop them.
-
4:51 - 4:55Meanwhile, smaller companies
that successfully bring new antibiotics -
4:55 - 5:00to market often still go bankrupt,
like the American start up Achaogen. -
5:00 - 5:04New therapeutic techniques
like phages and vaccines -
5:04 - 5:08face the same fundamental problem
as traditional antibiotics: -
5:08 - 5:11if they’re working well,
they’re used just once, -
5:11 - 5:14which makes it difficult to make money.
-
5:14 - 5:17And to successfully counteract resistance
in the long term, -
5:17 - 5:21we’ll need to use
new antibiotics sparingly— -
5:21 - 5:24lowering the profits
for their creators even further. -
5:24 - 5:31One possible solution is to shift profits
away from the volume of antibiotics sold. -
5:31 - 5:34For example, the United Kingdom
is testing a model -
5:34 - 5:38where healthcare providers
purchase antibiotic subscriptions. -
5:38 - 5:42While governments are looking for ways
to incentivize antibiotic development, -
5:42 - 5:45these programs are still
in the early stages. -
5:45 - 5:48Countries around the world
will need to do much more— -
5:48 - 5:52but with enough investment
in antibiotic development -
5:52 - 5:55and controlled use of our current drugs,
-
5:55 - 5:57we can still get ahead of resistance.
- Title:
- How can we solve the antibiotic resistance crisis? - Gerry Wright
- Speaker:
- Gerry Wright
- Description:
-
View full lesson: https://ed.ted.com/lessons/how-can-we-solve-the-antibiotic-resistance-crisis-gerry-wright
Antibiotics: behind the scenes, they enable much of modern medicine. We use them to cure infectious diseases, and to safely facilitate everything from surgery to chemotherapy to organ transplants. But we’ve stopped discovering new ones and we’re at risk of losing them forever. How did we get into this situation? Gerry Wright shares what we can do about antibiotic resistance.
Lesson by Gerry Wright, directed by Artrake Studio.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TED-Ed
- Duration:
- 05:59
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