By Almas Shamim

A few decades ago, acquiring a serious infection like Tuberculosis would have reduced chances of survival manifolds. Not just TB, but many other infections expressed all their severity in the times bygone. Things changed dramatically with improved living conditions and then with the introduction of medicines that could help combat these diseases- the antibiotics.

Innumerable lives have been saved by the use of antibiotics. Perhaps it was possible for you and meto be born because our parents and grandparents could live on and not succumb to deadly infections – owing to antibiotics. However, things won’t remain the same forever. Soon, all the known antibiotics would be rendered useless and we all would be again susceptible to deadly infections that have no cure. And this will occur due to the sharp rise in “resistance”.

The same evolution that helped man to walk on two feet and rule this planet- also helps other forms of life. The micro-organisms too evolve into forms that are better suited to survival with changing times. So, if a medicine acts in a particular mechanism to kill the organism, the organism mutates and evolves into a form that can overcome that mechanism of the medicine. Such mutations are boosted when the organisms are acted upon by incomplete courses of antibiotics, meaning, when we don’t complete the full course of antibiotics as prescribed by our doctor, we are aiding in the spread of resistance that will soon lead to a “no-cure” situation in the world.

We may be forced to believe that with newer and stronger organisms, newer and stronger antibiotics will also come up but sadly, that does not seem to be the case. Man’s technological advances are not keeping up with nature’s evolutionary progress and the new antibiotics that are being made are not sufficient to deal with all the newer forms of organisms and diseases that are on the rise. Funding is another big reason why newer antibiotics may not see the light of day. Research and development that is needed for newer drugs is mostly triggered by pharmaceutical companies that are mostly based in American and European countries and tend to stick to medicines that are more profitable- so, they focus more on developing medicines for diseases that are commoner in the Western countries than in countries like India/ Bangladesh/ Pakistan/ Nepal- because of the better market. So, though the need for newer antibiotics is on the rise, the market feasibility is still not great enough for the pharmaceutical giants to invest in this sector. Hence the threat of rising resistance becomes all the more large.

Many times doctors are forced into prescribing antibiotics by patients themselves. We question the competence of a doctor if he/she has not prescribed us a strong antibiotic for a week. It is said that “without medicines a cold lasts for 7 days, and with medicines, only for a week”. While this, of course, is just a saying, we must be careful in deciding whether we really need a course of antibiotics for a common cold (which is mostly viral) that usually resolves by itself. Though proper treatment- choosing the right antibiotic and proper adherence to the prescribed course-is important, the best way would obviously be that of prevention. Preventing infections at home/ school and workplace would involve simple steps such as washing hands properly before taking food and after defecation, using a handkerchief to cough or sneeze into and later washing the handkerchief properly; good cross ventilation is also extremely important in reducing the chances of exposure to an infective organism. Apart from this, the govt. should also ensure proper infection control in hospitals and all public buildings to reduce the chance of exposure to infection. Incorporating public health engineering into construction practices goes a long way in ascertaining infection control measures.

November 16- 22, 2015 was observed as the World Antibiotic Awareness Week. We must resolve that the awareness should be spread and instructions followed for more than just one week in a year.

To sum it up:

*Take precautions such that we don’t acquire infections

*Choose antibiotics properly, if at all! Drug sensitivity testing, though not commonly available and practiced, can help tremendously in choosing the correct antibiotic.

*Complete the full course of antibiotics. Before changing medicines, consult your clinician.

*During the course of the infection, adopt further precautions so that it is not transmitted to others.

*Never stigmatize the patient! Never!

For more info on Antibiotic Awareness, visit:

http://www.who.int/mediacentre/events/2015/world-antibiotic-awareness-week/en/

Almas Shamim is a public health specialist with a great interest in sexual and reproductive health and rights, and feminism among Muslim women. She currently works for an international humanitarian aid organization in New Delhi