Book review - The drugs don't work

A review of Professor Dame Sally Davies' book on the threat of antimicrobial resistance, by Dr Jeremy Phipps

Not a discussion on the track by The Verve, but an apocalyptic view of the potential dangers to society from antimicrobial resistance, written by UK chief medical officer Professor Dame Sally Davies.

Written in an informal style for wider debate beyond scientists, this short book provides a brief history of the rise of antimicrobials, from Fleming's chance discovery through the work of Chain and Florey in Oxford to the production of penicillin and other medicines against infectious disease, before discussing current and future difficulties.

The book's subtitle, A Global Threat, is exemplified by the statistic that 25,000 people a year die in Europe due to drug-resistant bacteria.

The rise in international travel is enhancing the transport of these bacterial strains, aggravating the global threat.

Counterfeit medicines

Counterfeit medicines are identified as another problem, with their potential to give suboptimal doses of antibacterials encouraging the proliferation of resistant strains.

Crop spraying may also have a deleterious effect on antifungal medicines, allowing the so far undeveloped proliferation of fungi resistant to treatment. Farming practices are further criticised for widespread use of antibacterials in animal feeds, both in the prevention of infection, especially in intensive farming, and more controversially as a growth promoter for healthy animals.

Both of these practices have the potential to allow further resistant strains of infective agents to develop in animals and then be passed to humans.

A doomsday scenario is discussed, but there are also positive suggestions for preventing this. These include improvements in hygiene, changes in farming, reduction in antimicrobial use and greater international co-operation in these and other areas, including the production of new medicines.

This co-operation is compared with that against climate change and led me to realise the main reason for this book is to encourage wider public education.

Responsibility

Dame Sally has likened this educational process to that for climate change and her concerns mirror former US vice-president Al Gore's view: 'This crisis will get resolved only if individuals take responsibility for it. By educating ourselves and others, each of us can make a difference.'

I am not sure a small paperback will contribute greatly to the debate, even though it is written in an informative style, but let us hope so.

  • Dr Phipps is a GP in Market Deeping, Lincolnshire
  • 'The drugs don't work, a global threat' by Professor Dame Sally C Davies is published by Penguin. ISBN 978-0-241-96919-9.

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