Which will kill us all first: AMR or climate change?
In my book I tell the story of a 70 year old woman who died in Reno, Nevada in 2016. She was killed by a species of bacteria that is normally harmless and readily treatable. But the particular strain that infected her was completely resistant to every single antibiotic licensed for use in the US. There was simply nothing her doctors could do to save her.
The UK Government’s Chief Medical Officer Dame Sally Davies has been in the news recently (see this piece, alongside several others https://www.theguardian.com/society/2019/apr/29/antibiotic-resistance-as-big-threat-climate-change-chief-medic-sally-davies)urging people to remember that deaths like this will become far, far more common if we do not take drastic action to confront the looming crisis posed by antimicrobial resistant infections.
The thing that hit the headlines was Dame Sally’s repeat of a claim that she made when I spoke to her whilst researching my book. She said that the threat posed by antimicrobial resistance was as great, or perhaps even greater, than that posed by climate change. I wholeheartedly share her concern and endorse her call for more organised and concerted action to rise the this great challenge, but I want to point out that AMR and climate change are problems of a rather different kind.
For me, the key difference is that when it comes to tackling AMR, focussed investment and rather specific regulatory changes could have a fairly rapid and profound effect. If society can provide the right economic incentives, there I have little doubt that the pharmaceutical sector could discover or construct powerful new broad-spectrum antibiotics. It would also be relatively straightforward for many governments to outlaw the use of low dose antibiotics on farm animals. Together, these two actions would go a long way.
When it comes to confronting climate change, we know what the ultimate solution is – reducing the emission of greenhouse gases into the atmosphere – but there are many, many possible ways to achieve that end. And, what is more, making it happening quickly and far-reachingly enough will require a systematic reappraisal of the entire energy infrastructure that powers our world. This, at least from my perspective, makes climate change no less critical, but likely an even bigger and more expensive problem that must be solved.
In short, AMR and climate change both stand as the two of the most urgent threats to our future. As a society we must act fast and act decisively on both fronts, but they will require rather different fixes. I suspect and hope that when health services start being confronted by many more completely drug resistant infections like the one that killed that unfortunate woman in Reno, we will find the wherewithal and the political will to solve the AMR crisis more quickly. The big question is, will there ever come a moment when people and policymakers are spurred into action by seeing people dying before them as a direct consequence of climate change?