My thoughts on the antibiotic crisis

For any budding student slightly interested in medicine, science and any interested in current affairs the antibiotic resistance crisis would no doubt have found its way into your thought process at some point. I know it is often on my mind.

The crisis of antibiotic resistance is one that is often documented in the media, and it is in my opinion one of the biggest challenges that modern medicine faces. In 2013 alone, there were about 480 000 new cases of multidrug-resistant tuberculosis according to WHO, this to me is slightly terrifying as without antibiotics we return to the pre antibiotic era, where whether you survived tuberculosis or not was down to sheer luck.

It’s a situation where I am not sure what the answer is, and I don’t expect to know the answer quite frankly, I’m not sure anyone really does. There is of course things we can do as a society to prevent the situation escalating more than it already has, by not overprescribing or overusing antibiotics, having a general understanding of antibiotics and antibiotic resistant. However, I personally fear that it is a situation where antibiotic resistance will occur regardless of our efforts to prevent it, in fact thanks to Darwin and the theory of evolution we know this to be true. The selection pressure that is antibiotics will naturally cause bacteria to evolve to become resistant to them.

So what is the solution?

To me, with what many may call naïve optimism, due to my age, I would say let’s find an alternative to antibiotics. If you ask me what that is, I will tell you this; at the moment I do not know. Yet, I do have ideas and one of them is thanks to my EPQ project, it is called phage therapy, and I will not delve into the technicalities of it at this moment, for I want to keep my posts as short and snappy as possible, but I will say if you are intrigued or rightfully concerned by this global crisis, I say do a bit of research. Phage therapy is highly under researched and doesn’t have the best reputation due to past research and trials, but it is if anything a fascinating idea, and even if it isn’t a possible solution to this crisis it’s worth a look up either way.

India vs UK healthcare

India has the ninth-largest economy in the world by nominal GDP and the third-largest by purchasing power parity (PPP) [1] and despite this much of India still remains as a third world country. Over October half term I had the experience of visiting Goa, India for two weeks, the trip was predominantly to visit family. However, whilst I was there I was able to witness the huge cultural  difference of India compared to the UK, not only in attitudes towards lifestyle and people, but also a particular difference in attitude and approach to healthcare.

Unlike the UK healthcare is not free at point of use in India (i.e. there is no NHS), and as a consequence of this the attitudes to healthcare are very different, below I will outline some key observations I witnessed whilst in India:

·       I noticed that many of the people who were begging and living on the streets often had a limb missing or some form of disability. I believe that this shows how many of the poorest in India  are unable to afford healthcare, and often they are those who are most in need.

·       One huge contrast to me, which actually shocked me significantly, was the ease of buying medicines from a pharmacist that would require a prescription from a healthcare professional in the UK. I also say pharmacist very loosely, since the pharmacies themselves were normally a shack on the side of the road, and upon entering you would tell the pharmacist your symptoms, and they would return with an antibiotic or other medicine, at an extremely cheap price. For example, whilst in India I contracted the ‘delhi belly’ and my mum was able to buy medication for me at 30 rupies, which is about 30p. Whether the ease of gaining prescription medication is a good thing or not is up for debate. It certainly helps fuel the misuse of antibiotics and hence the antibiotic crisis. However, having said that I know that the day I woke up feeling extremely ill, I was very thankful of the ease of access to medication.

·       The final contrast I noticed was the public health campaigns, in particular the appeal regarding smoking. I would spend much of my afternoon, when the heat was unbearable, watching a movie, and I noticed that if within that movie a character was smoking, then a banner would come across the screen declaring that smoking was dangerous. I cannot remember the exact wording, but the banner in short explained how it can lead to serious health complications and even death.

Overall it is quite easy to say that the healthcare in India is extremely different to the UK, and it made me appreciate how fortunate I am to have a solid healthcare system in the UK. The NHS allows society to gain healthcare whatever your income, and to me it the fact that it is free at point of use is extremely important and extremely beneficial. I also think that the fact in India one can obtain any medication over the counter at such ease is a problem, as it gives rise to misuse, and of course resistance, which is becoming a huge issue in global healthcare. The trip itself was enlightening, and showed me just how different the approach to healthcare is for different countries.

[1] http://www.rediff.com/business/slide-show/slide-show-1-special-25-interesting-facts-you-must-know-about-the-indian-economy-/20130808.htm

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'The magical healing powers of turmeric'

I recently spent my October half term in Goa, India visiting family. My family who live there are quite remarkable; they moved from England to Goa about 17 years ago, whilst Goa was still a destination for ‘hippies’ so it comes as no surprise that they, and in particular my Granddad, are full of weird and wonderful facts. Often we will just be sitting talking and my Granddad will burst out with an anecdote about travelling in Thailand or Cambodia and often I just laugh at them, never really taking them seriously. However, one morning we were sitting in the usual French bakery for breakfast and he starts talking about the benefits of turmeric as an antiseptic or how he worded it ‘the magical healing powers of turmeric’. The story came about as his cat had an infection on his head, from a cut, so my Granddad proceeded to ‘slap some turmeric on his head, and the next day boom the infection was healing’. After a few more stories about the animals he has saved through the magic of turmeric he showed me how he was also using it on his foot for an infection, and it seemed to be working.

Normally I do not think much of holistic medicine, and on that trip I was particularly sceptical as I had just been reading Bad Science by Ben Goldacre, yet my Granddad’s stories seemed to good to be true, so I proceeded to do some research on ‘the healing powers of turmeric’.

It seems that many others have been curious on turmeric’s effects, and it has in fact been used for over 4000 years to treat many conditions as an anti-inflammatory, antiviral, antioxidant, antifungal, commonly used in Chinese and Ayurvedic medicine. It is even said to help fight some cancers! However, the evidence gathered appears to be conflicting, like much of the evidence with regards to holistic medicine, and it is suggested that the effects of turmeric may not be as good on humans as it is for animals.

Despite this it does seem that there are some benefits of turmeric, and my Granddad may be right, so below I have left some links to some interesting websites on ‘the healing powers of turmeric’ for you to make up your own mind.

http://umm.edu/health/medical/altmed/herb/turmeric

http://www.drweil.com/drw/u/ART03001/Three-Reasons-to-Eat-Turmeric.html

http://www.webmd.com/vitamins-supplements/ingredientmono-662-turmeric.aspx?activeingredientid=662&activeingredientname=turmeric

http://www.ncbi.nlm.nih.gov/pubmed/17569207