Socialist Worker

Infected by profit system

by Paul McGarr
Issue No. 1831

'SUPERBUG SWEEPS Hospitals'. 'Sharp Rise In Superbug Deaths'. These were just some of the headlines in the papers last week. The spark was a study in the British Medical Journal showing hospital deaths from the 'superbug' MRSA had risen. MRSA is a bacterium resistant to key antibiotics.

It raises the spectre of a return to the days before antibiotics were widely available. MRSA is a type of common bacteria called staphylococcus. It can cause infections, especially among elderly or frail people. People in hospitals are therefore more prone to infections.

That bacteria evolve resistance is down to evolution by natural selection, Charles Darwin's famous explanation for how biological change proceeds. Faced with antibiotics, bacteria which have some random genetic variation giving them resistance are more likely to survive and reproduce, making the resistance more widespread.

In a hospital environment resistance to antibiotics can be the key to bug survival. This is all biology. But why this should be causing problems is not simply biology. Five key factors are involved. All are linked to profit chasing.

1. Standards of hygiene in hospitals have got worse. Before antibiotics hospitals' only defence against infection was strict hygiene. A more relaxed attitude developed with the coming of antibiotics. A shift back to strict hygiene is needed.

Privatised contract cleaning has made hospitals dirtier. So has the cost cutting which has led to poorer NHS laundry facilities, and longer waits for clean uniforms or bed curtains.

This leads to huge problems of staff retention, and the routine use of temporary and agency workers. What is needed is properly resourced hospitals where hygiene is the priority.

2. In countries like Britain antibiotics have been overprescribed by doctors. Doctors have been pressured to prescribe antibiotics when they are not needed, most typically for colds, flu and other viral infections against which antibiotics are useless.

This widespread use of antibiotics outside of emergency situations can help spread resistance. In part this overuse is down to doctors being bombarded with advertising and other pressures from drug firms to prescribe their product. It is also down to overstretched doctors reacting to pressures from misinformed patients.

The answer is better public health campaigns to inform patients, and doctors having more time for consultations.

3. In poorer countries antibiotics can be dangerously misused. The worst thing to do with antibiotics is not to complete a course of treatment. The most resistant bugs are those that will then survive and reproduce. This is what happens when drugs cost money and people are poor.

The answer is to make drugs free-but that would be resisted by the drug companies, and bodies like the IMF and World Bank.

4. Drug firms are not that interested in developing new antibiotics as they don't think there's enough profit in it. Giant drug companies like Wyeth, for example, have laid off 90 percent of their antibiotics research staff.

Nationalising drug firms and funding research based on human need, not company profits, is the answer.

5. Massive and unnecessary use of antibiotics in agriculture is spreading antibiotic resistance. In the US around 70 percent of all antibiotics used are for animals. Some are used to control disease, a lot of which is down to overcrowded, unhealthy, factory farming conditions.

A lot are used because in low doses antibiotics promote rapid meat growth, and hence more profit. The price is more rapid spread of antibiotic resistance. This has already happened.

The World Health Organisation says, 'Some of the newly emerging resistant bacteria are transmitted to humans mainly via meat and other foods. 'The best known examples are the foodborne bacteria salmonella and campylobacter. These bacteria emerged shortly after the use of certain antimicrobials [antibiotics] in agriculture.'

Added to this is the routine addition of antibiotic resistant genes to genetically modified plants by corporations. They do this as a cheap way to test if the plants have been successfully modified - by dousing them all in antibiotics and seeing which survive. Tackling the threat of superbugs is relatively straightforward on one condition - that health and human need, rather than profit, inform every sphere of society.


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Features
Sat 21 Dec 2002, 00:00 GMT
Issue No. 1831
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