When Superbugs Attack

Antibiotic-resistant NDM-1 Is Undermining India's Medical Sector

Escherichia coli NDM-1 growing on Oxoid Brilliance CRE Agar. Click here to see her slideshow "A Global Crisis in the Making: Super-resistant Bacteria, Medical Tourism and India's Poor." (Image: Nathan Reading / flickr)

Some of modern medicine's most heralded interventions -- from routine surgeries to organ transplants and cancer treatments -- may soon be too dangerous. The viability of these procedures hinges on physicians' ability to use antibiotics to swiftly vanquish any bacterial infections that might arise in the course of treatment. For decades, physicians have been able to choose from hundreds of different kinds of antibiotics to do the job, including many powerful "broad spectrum" varieties that indiscriminately kill a wide range of bacteria. But over the past two decades, antibiotic drugs have started to fail one by one, as bacteria with resistance to them have emerged and spread. Taming the new drug-resistant pathogens requires ever more toxic, expensive, and time-consuming therapies, such as a class of last-resort antibiotics called carbapenems, which must be administered intravenously in hospitals. In the United States alone, fighting drug-resistant infections costs up to 8 million additional patient hospital days and up to $34 billion every year.

Now, the emergence in India of a particularly nasty form of antibiotic-resistant bacteria, which renders even the last-resort drugs obsolete, could bring about an era of unstoppable infections. To contain the bacteria, South Asian governments must quickly reform their public health practices and medical manufacturers must fast-track the development of new drugs. But with the Indian political establishment prioritizing building up its lucrative private health sector over making costly public health reforms, and policies aimed at recalibrating drug research and development in the West stymied, the political will to accomplish the job is scarce.

Read more at at Foreign Affairs' Special Report: Global Public Health.

In India, antibiotic use is virtually unregulated. Antibiotics are widely available without a prescription and, as in the United States, affluent people tend to consume the drugs whether medically necessary or not -- for everything from

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