Treating a World Without Antibiotics?

Doctors in India have reported recent cases of what the medical world calls "Totally Drug Resistant" tuberculosis. In other words, none of the antibiotics we have today are effective in treating this particular strain of TB. What happens next is far from clear.

We shouldn't be surprised. Resistance to antibiotics has been a deep and growing concern for decades as their overuse comes home to roost.

This was one of the topics we discussed last week at the World Economic Forum in Davos, in a session titled: "What if All Known Antibiotics Lost Their Effectiveness?" Life without antibiotics would recreate the world of Dickens. Pneumonia could become a mass killer, childbirth could become a potentially life threatening event, incurable tuberculosis could return us to the days of Mimi in "La Boheme," and many basic surgeries and dental procedures would be impossible without the ability to fight infections.

Just a science fiction nightmare scenario? The unfortunate truth is that because of the overuse of antibiotics, resistance is developing all of the time. With microbial evolution outpacing human invention, this scenario is possible.

So what would be the global implications of a world without the use of effective antibiotics? Clearly, a dramatic increase in demand for pharmaceuticals, health care products and services would put a major strain on the global supply chain. Any minor disruption in any part of the medical supply chain, largely based in developing countries such as India, China and Malaysia would have cascading effects on the ability of nations to respond. Absenteeism in the workforce would become a major issue. Ensuring the effective distribution of basic hygiene products (including gloves, gowns, masks, and antiseptic wash) would face formidable global logistical challenges, such as customs clearance and supply chain breakdowns. All of these issues are similar to the challenges that we have faced in our response to natural disasters through Henry Schein Cares, our global corporate social responsibility program which distributes medical supplies to stricken areas. These are the challenges we are working so hard to overcome through public-private partnerships such as the World Economic Forum Global Agenda Council on Disaster Management.

How can we change this disaster course? First, we must do everything in our power to prioritize our stewardship of the antibiotics that we have. The profligate use of antibiotics occurs in part because patients demand them whether they are warranted or not. There is a strong need for enhanced collaboration among scientists, clinicians, policy makers, and private industry, including distributors of health care products and manufacturers, to promote appropriate use and to stockpile antibiotics for emergencies. We also need better tools for accurate and early diagnosis, which leads to earlier treatment with the appropriate antibiotic. And, this is not just an issue in human health. Although antibiotics are a powerful tool for veterinarians to promote animal health and welfare, inappropriate use has led to the serious issue of antibiotics resistance among livestock, which further contributes to human resistance. Likewise, inter-governmental and industry cooperation will be essential in dealing with the ubiquitous use of antibiotics in animal feed as well.

Beyond education and better regulation, vaccines are an excellent tool in our antibiotic preservation arsenal. Why? If we can prevent the disease to begin with, we won't need an antibiotic to cure it. Although we have made tremendous progress in making lifesaving vaccines available around the globe, there are many formidable challenges, such as competing priorities, inadequate health systems, unfounded fears of vaccination, and funding gaps that must be addressed. As a leading distributor of vaccines to office-based practitioners, Henry Schein stands ready to do its part.

Lastly, with a weak pipeline of new antibiotics on the horizon, there is clearly a need for vigorous R&D to create new antibiotics in our arsenal. But there is an economic obstacle as well. Because antibiotics are prescribed for a relatively short course of treatment, our manufacturing partners in the pharmaceutical industry face of a lack of return on investment for developing new antibiotics. Here, public-private coordination and more robust government incentives can help align the public good with business objectives.

Just recently, the Global Fund to Fight AIDS, Tuberculosis and Malaria announced that no new grants would be approved before 2014 due to a sharp drop in donations. This is a stark reminder that increased global financial constraints mean that we could lose the precious ground that we have already gained in our fight against these "big killer diseases." In light of the potentially devastating global health threat that Multi-Drug Resistant Tuberculosis poses, the work of organizations like the Global Fund is even more essential today than it ever was. Our challenge: How can we mobilize governments and other sectors to enhance support for crucial institutions like the Global Fund in economically challenging times like today?

We cannot afford to wait for this potential nightmare scenario to take place before we act. Preparedness is prevention. Clearly, all sectors, including governments, intergovernmental organizations, NGOs, academia, and the private sector, have an essential role to play. This is a job for all of us and it must begin now.

Stanley M. Bergman is Chairman and CEO of Henry Schein, Inc., a Fortune 500® company and the largest distributor of dental, medical and animal health products and services to office-based health care practitioners, with more than 14,000 employees and operations or affiliates in 25 countries.