Friday 22 March 2013

RESISTANT BUGS AND THE FUTURE OF ANTI-BIOTICS

Professor Dame Sally Davies is one of UK’s most distinguished medical professionals. She is England’s Chief Medical Officer and was Director General of Research and Development and Chief Scientific Adviser for the Department of Health and National Health Service. Actively immersed in the business of disease and hospitals since 1972 when she qualified as a medical doctor in Birmingham, the 63 year old Professor is also a “dame” which is the feminine equivalent to “sir”; titles given for highest services in this Queen’s nation.


 Apart from numerous ranks, Professor Dame Davies (pictured in 2011) has been engaged in research for sickle cell disease where red blood vessels assume an abnormal, rigid bent shape and shorten lives. Majority of affected are blacks and people from sub tropical, Saharan area, or where Malaria is common.  Listing her brilliant credentials and activities here will reduce this column to some biographical data which many in East Africa may find irrelevant; but, here comes the reason.
Two weeks ago, I caught the professor giving a very stern caution on television regarding the state of the health service today.


She warned that there is a “catastrophic threat” from ailments resistant to anti-biotics.  Apparently no anti-biotics have been discovered since 1987 because big pharmaceutical companies are not investing in research any more; reason being that there is no money to be made. Global action has to be taken just like in terrorism or the lethal flu epidemic.

This is an “international threat” she went on; in past five years various fatal diseases such as the blood poisoning E-Coli bug (pictured).... have gone up by 60 percent. In the bygone 15 years cases of resistant TB (“which endures all types of drugs”) have emerged in the UK. Six decades back, TB used to be a worldwide killer.
Scurvy victim from Wikipedia...

OK. These are just a few rings from her alarm bells. Let us put them into perspective. Why did this experienced doctor compare the impending doom to that of 19th century where many diseases that are treated easily today slaughter millions? Take scurvy an ailment that extinguished sailors and travellers to the beginning 1900s due to lack of vegetables and fruits which provide Vitamin C. Those days loss of vital parts of the body and lethargy – the “slow death”- was as bad as HIV is, presently: mass killers. The importance of Vitamin C is general knowledge now.
Fruits such as these  are a rich source of Vitamin C...

Or think of penicillin’s breakthrough. Before Scottish scientist and Nobel Prize winner, Alexander Fleming discovered penicillin antibiotics were uncommon. The power of penicillin is also general science, today.
Professor Dame Sally Davies further said the danger of current anti-biotics not working is that you could have a simple wound or a small operation and die from it. That is all thanks to bugs and bacteria becoming resistant to anti-biotics.
Tetracyclene (pictured) was easy to obtain and a "big friend" back in the  pre- HIV days...

During the late 1970s, I remember we easily bought Tetracycline (sometimes on black market) for a number of serious diseases e.g.  Gonorrhoea. You did not need a prescription, even if you did, knowing or pleading with a doctor was enough. When I lived in Latin America twenty years ago, it was paradise. Pharmacies were open 24 hours; anything you wanted was (I don’t know if it is still the case), available.
Coming to London in late 1990s I was kind of offended when doctors were reluctant to offer anti-biotics freely. Once I had a terrible cold, the doctor said: “Go home, take warm drinks, stay indoors and rest. The cold will eventually go away.”
I protested: “But doctor, this might get more serious and-”
He cut me. “Kill you?”
I said: “Yes. You hear these stories all the time. Someone had a cold, it wasn’t treated and died.”
The doctor did not laugh but scratched his chin. What a nice chap.
He said: “Look.  I have your medical history here. You are quite healthy. Your blood pressure is fine, the cold will go away. If things get worse in four, five days come back we shall prescribe anti-biotics.”
The cold did indeed, leap away. I thank that doctor for being sensible.  I never go to the hospital when I have a cold. I know colds can be symptoms for an overworked body, lack of sleep, depleted immune system etc.
Here is the moral of the story.
Using too much anti-biotics has toughened bugs. It is like those of us who used to be whipped a lot as kids. You developed a thick skin called “Sugu” in Swahili. 

Meanwhile, alternative medicine is offering solutions, especially from the unknown world. It has been reported that Manuka honey from New Zealand- used for centuries by Maori tribes- has anti-septic properties that can combat 80 types of bacteria. Manuka is one of the most expensive honeys in the world costing an average 10 pounds (approx 25,000 shillings) for a small 250 milligrams bottle.



Also published in Citizen, Dar es Salaam, Tanzania...Friday 22nd March, 2013.

1 comment:

  1. I appreciate your article...Well done, especially for the history of your medical contact with a serious practitioner in UK: it will teach many others. Actually this is what does not happen in Tanzania: people with minor ailments(mostly of viral etiology) go to a private dispensary and instead of having a simple good advice they are treated with antibiotics. Read Gwimile et Al, over-prescription of antibiotics, KCMC, Moshi(open google at this item). Too many antibiotics(80% of children leave the ambulatories WITH an antibiotic prescribed!) and , in my opinion, also too many laboratory tests, such as Widal test that is obsolete, fallacious, not any more used in western countries.
    Kindly consider the points:
    1)prescribing and delivering of drugs in the SAME building/setting is wrong. More a doctor prescribes and more the dispensary will gain from the selling of drugs. A real conflict of interest. Do you agree? why not to change this situation? Pharmacies are all over, why then should the dispensary be allowed to sell drugs? mind you that they will prescribe and then sell more and more expensive drugs in order to get more profit?
    2) so far there is any indicator of performance that shows the correct prescribing behaviour, internationally. I mean, a threshold of % patients that receive an antibiotic . Based on my practice (I am in Tanzania for over 30 years) 20% of children AND NO MORE should leave the dispensary With an antibiotic. 80% is definitely wrong and must be corrected.

    Consider the cost of prescribing too many drugs, money taken from the pockets of Poor families, more drugs to be imported by the Government, beside the resistance to antibiotics.

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