Let's Fine Countries That Overuse Antibiotics
WHY YOU SHOULD CARE
Because they’re creating tomorrow’s superbugs.
By Fiona Zublin
French veterinarians are oh-so-French: They tell you to feed your cat cheese and help guard him against ennui. But they’re different from U.S. vets in less innocuous ways, too: Last visit, my vet inspected my kitten, announced that any number of things could be wrong and then handed over an antibiotic — 400 percent of the required dose, with careless instructions to give le chaton more whenever I thought it appropriate.
France is just one country that’s struggling in the fight against antibiotics overuse. According to a new report, India, China, Korea and the U.S. are all popping the pills with unnecessary regularity, shoving animals, humans and livestock so full of drugs that your average bacterium has lots of chances to evolve its own resistance and render that antibiotic essentially useless. The World Health Organization, which did not respond to requests for comment, and a myriad of others agree: We need to cut back on the antibiotics. But how?
Let’s make countries put their money where their medicine is — with fines for overuse.
“Anywhere we use antibiotics, we’re creating resistance,” says Steve Roach, a spokesman for Keep Antibiotics Working. The good news is that the solution is simple: Reduce use. The bad news is that’s pretty much the only solution, and it’s a very tough pill for some nations to swallow. Regulation varies wildly by country — some European nations keep antibiotics from being sold over the counter, while others have reduced antibiotic use through education.But some countries aren’t even at the planning stage to restrict sales of antibiotics — in France, antibiotics are a routine part of medical visits, and public expectation can trump things like the fact that they don’t do squat for the common cold. Meanwhile, countries like India, Vietnam and Romania already exhibit high rates of resistance to antibiotics from overuse.
The World Health Assembly, part of the WHO, has made a resolution and even an action plan to fight antibiotic resistance. But telling countries what they ought to do and actually getting them to do it are two different things. Even countries committed to reducing antibiotic use internally just kind of have to hope that everyone else is on the same page. Hope is all fine and good and often futile. Monetary penalties tend to work better.
There are reasons not to do it — for one thing, some nations that overuse antibiotics don’t have the infrastructure to use them properly. And enforcement, which would likely require oversight of doctors, would be difficult: With incentives as they are, prescribing a medication is easier than explaining to a patient why she doesn’t need it, says Dr. Henry Chambers, chief of the Division of Infectious Diseases at San Francisco General Hospital. “The default is that because antibiotics are nontoxic and easy to give, you err on the side of giving the antibiotic.”
Money from the fines could go toward campaigns educating both doctors and the general public about the dangers of their actions, and toward developing low-cost tests to check for bacterial infections, like the rapid strep test. Who knows, soon enough we could be tackling ancillary problems, like how to get antibiotics to those who actually need them and have no access. All of which is to say: Let’s give the world’s antibiotics overusers a dose of reality.