Sunday, February 1, 2015

Nobel Prize Winner's solution to antibiotic resistance and additional editorial comment

Contributed by: Dr. Akilesh & Dr. Tamhankar

Venki Ramakrishnan, a Nobel Prize-winning chemist based at the Laboratory of Molecular Biology at the University of Cambridge has expressed his views on the issue of antibiotic resistance and solutions to this problem in an interview to Scientific American Forum.
Some key concepts from his interview is highlighted below:

1.  Why not many new antibiotics ?
Most researches in pharmaceutical industry is targeted towards modifying existing antibiotic compounds than researching for new compounds as new compounds must not only be able to kill the bacteria but also be cheap to manufacture and safe for use. To develop such compound, it'd take more funds and research. Resorting to modification of an existing chemical compound has become the cheaper solution, perhaps.

2.  New antibiotic discovery - Is it the panacea for all our antibiotic problems ?
The Nobelist has expressed his reservations on the premature hype surrounding the new antibiotic discovered. It represents a new class of antibiotics and an interesting development with claims of no known antibiotic resistance to this class of antibiotics. The finding seems to hold a lot of promise, but the same has been said earlier about other antibiotics as well and Mother Nature has an excellent capability for natural selection and such comments must be made with caution, he added.

3. The problem of antibiotic resistance
He also quoted the scenario in India contributing to antibiotic resistance as follows
In countries like India people will give you antibiotics prophylactically, as a way to prevent infection. This should only be done in very extreme cases because it’s again spreading resistance.
4.  Government's role in antibiotic research
Most important opinion that he voiced was that the research and funding for development of antibiotics must be supported by the Governments. Antibiotics have a limited period of use, unlike other drugs for 'lifestyle' diseases (which must be used throughout the patient's life). Hence, the funds put for development of an antibiotic is not got back by Private Investors. This leads to a limited fund allocation for development of antibiotics. This is also complicated by the limitation in use of such new antibiotics which are preferably used as a "last resort" further limiting their use and in turn meaning lesser monetary returns to the company.

Interview Edited Transcript Source: SA Forum

Editorial Comment
These opinions of a Nobel Prize winner has immense importance. It not only highlights the problem of antibiotic resistance but also points to important challenges in the field of antibiotic development and research.

In order to counter this scenario, Government must consider funding more for research in antibiotic development, prevention of antibiotic resistance. There is a constant riff between the traditioanl systems of medicine and allopathy always. But, even WHO recognized that in countries like India, China and other Asian countries have a rich and ancient traditional medicine knowledge base which is under utilised. WHO has also suggested improved utilisation of such traditional knowledge base for betterment of healthcare. This is already part of the current Indian Government initiative in the form of AYUSH.

Will these moves improve our healthcare system ? Will it result in lesser antibiotic usage ? Will it decrease antibiotic resistance ? Only time can answer these questions. But definite proactive measures are required for better results in this pandemic issue of antibiotic resistance.