Wednesday, September 24, 2014

Pharma Chameleon

(Published in Business Standard on May 3, 2014)

When I was a kid I would frequently eat a whole bottle of Nux vomica or Rhus tox or Belladonna at bedtime. If you know homeopathy, you know that you’re only supposed to put four little pellets on your tongue, and that they are very effective at being delicious little balls of sweetness that stand in for dessert. I just pounded the whole bottle, and today I am a short, podgy person whose brain moves very slowly. That’s the sort of thing that happens when you recklessly overuse medication.

So here’s a public service announcement: Please listen to the World Health Organisation, which is screaming at us to kindly stop popping antibiotics as if they’re mints. I know countless highly educated people who are always buying antibiotics over the counter without a prescription (lousy idea) and self-medicating (big problem) for as long or as short a time as they feel like (enormous disaster). Stop it, would you? You’re screwing it up for the whole planet. Just because Dr X once gave you amoxicillin for five days when you had that thing, doesn’t mean you should now take it for two and a half days because you have a thing that feels a bit like that thing. Doing that makes you public health enemy number one.

Science long ago confirmed what we secretly already knew: we are scum, mostly, even those of us who aren’t running for public office. The most populous form of life on earth is not, in fact, people who talk loudly on their cell phones in the middle of movies, though it feels like it—it is actually bacteria. There are about two kilos of bacteria in your gut, and while some of the rest of you is made up of water, a lot of the rest of you is just creepy crawlies. Most of the world is bacteria.

Bacteria didn’t get this dominant by being stupid; they are champion survivors. If you throw a problem at them for long enough, they’ll figure out how to solve it. We’ve been throwing antibiotics at them for decades. Now tiny, revolting little bacteria scientists are beginning to publish, in their tiny, revolting little peer-reviewed bacteria medical journals, breakthroughs in beating antibiotics.

Our scientists, on the other hand, are saying very loudly that we’ve got no new antibiotics, and no time to develop them at the pace that bacteria are outwitting them. That’s extremely scary. We’re so used to having these medical brahmastras around that we’ve forgotten that, before them, you could die from a common infection. As humans become resistant to antibiotics, therefore, we’re heading for a public health crisis in which the only thing that our last-resort medications are going to achieve, is gazillions of tiny, revolting little bacteria eyerolls and yawns. We’ll be in the space-and-communications age, and simultaneously in the 1940s. In this brave new world, you will be able to buy real estate on Neptune and send four trillion spam messages a day, but a paper cut could kill you.

India being India, you have to fill out seventeen different kinds of paperwork to join a library, but you can get serious medication from a pharmacy without a doctor’s prescription. Until pharmacies are made to stop flinging fistfuls of antibiotics over the counter with cries of merriment, the onus is on individual patients to cooperate. Yes, it’s a pain to go and pay a doctor, but think of it as helping to save the world. If that doesn’t move you, consider whether you really like the idea of getting untreatable gonorrhoea, or dying of a urinary tract infection.

That was for the rationalists out there.

The rest of you: NaMo says stop abusing antibiotics.

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