There is widespread recognition that we are now at the beginnings of the so-called post-antibiotic era. This is, in short, the time in which an increasing number of antibiotic medicines stop working because many types of bacteria have become resistant to them. The development of this resistance is a natural feature of living organisms that have to adapt to changes in the environment.
The generally accepted view is that antibiotic resistance is the result of decades of unnecessary consumption of antibiotics for minor infections and the widespread use of antibiotics in meat production. With the effectiveness of these antibiotics waning, people may also be struggling with infections and losing their limbs and lives because of the lack of research and development in the medical field, a field now mainly driven by profit interests. A survey of 11 large pharmaceutical companies, reported by Hausler, around 12 years ago revealed that only 1.25% of all substances developed were antibacterial drugs attributed to the skimpy profits in this sector.
The solutions suggested to address this crisis predictably include the cessation of the use of antibiotics in the meat production, the belated wise use of antibiotics, and, of course, the development of new drugs. Viewing these measures as useful but not sufficient, I am suggesting in this paper that antibiotic resistance should be viewed as a compelling challenge to re-examine some of the unsustainable beliefs held in conventional medicine and the general public. Space permitting, I will only be able to present here a small number of arguments in the hope that an ensuing discussion will further elucidate the salient issues.
Human beings are hosts of trillions of bacteria. In healthy people, these organisms live in symbiosis with us as much as our bodies are trillions of cells living in symbiotic and collaborative relationships, a phenomenon that Lynn Margulis has called endosymbiosis. These bacteria fulfil important tasks such as enabling us to digest food while they nurture themselves in the process, a scenario called mutualism. It is also well known that many people are so-called carriers harbouring highly infectious microorganisms in their bodies, often infecting others without getting sick themselves (commensalism). Both these scenarios demonstrate that our immunity more than the presence of microorganisms, determines whether or not we are symptomatic or asymptomatic carriers of germs, that is, whether we are actually sick or not.
Why, then, is it that conventional medicine rarely emphasises the importance of immunity and mutualistic relationships among organisms, but keeps portraying microorganisms as villains out to kill and maim us? Here we can see that we are all subjected to a societal paradigm of enemy-making and heroic fights against what are perceived as evil forces. The current paradigm urges us to 'fight' terrorists, Bashir Assad, Kim Jong-un, ISIS, Cancer, addictions, the drug trade, and possibly even people believing in climate change. The metaphors of war, competition, and one-upmanship have been the dominant paradigm for such a long time that it will require a fundamental paradigm shift to make people aware of the necessity to adopt a collaborative and ecologically sustainable worldview if we are to survive long-term as a species with some level of comfort. Whether or not we can create this shift without living through major ecological and social catastrophes can be anyone's guess.
Unable to change our ecologically destructive habits voluntarily, antibiotic resistance along with increasing numbers of natural catastrophes may be two of the challenges we need to reconsider and finally change our self-destructive and unsustainable practices. Interestingly, bacteria themselves can serve us here as role models for collaborative behaviour. In his 1977 publication 'Viren – Botschafter lebender Systeme' Wolfgang Pollmann pointed out that bacteria that synthesise genetic code to gain resistance against antibiotics freely share this code through tube-like connections with other bacteria both of their own and other species, or as we can read on the Antimicrobial Resistance Learning Site, "Many of the antibiotic resistance genes are carried on plasmids, transposons or integrons that can act as vectors that transfer these genes to other members of the same bacterial species, as well as to bacteria in another genus or species".
To be sure, gen-mediated learning, horizontal gen transfer as it is also referred to, is ubiquitous in nature and, interestingly, has now strong parallels in the sharing of information on the internet, a theme that deserves greater attention. Genetic code shared through tubes, or as the encapsulated variety that we generally call viruses, are intra- and interspecies learning systems that primarily serve to adapt to changes in the natural environment and to maintain a high level of biodiversity. In our oceans, for example, 90% of the biomass is microbial and viruses assist in modifying 20% of the DNA of this biomass daily. All this is done for the sole purpose of the survival and thriving of nature. Considering that this ecological learning and sharing system works without registered trademarks and profit motives, it is not difficult to see that humans are the ones sooner or later committing ecological suicide by sidelining themselves from this ecological cosmic 'game'.
Antibiotic resistance provides also a challenge to remember the basic duty of the medical profession, which is supposed to be based on the ethical principles of beneficence, non-maleficence, justice, and autonomy, principles enshrined in the 1948 (2006) Geneva Convention. The consistent violation of these principles has led to the astounding fact that iatrogenic illness, illness caused by the medical system, is now the 3rd most fatal 'illness' in the USA. While hospital and doctor errors mainly referred to by this type of 'illness' are concerning enough, so far very few, if any, serious attempts are being made to quantify unnecessary suffering in the population emerging from the current practice of curative rather than preventive medicine.
What, then does this all mean for us? We would be wise to regard antibiotic resistance as a challenge to more strongly raise public awareness on the psychosocial causes compromising our natural immunity to illness rather than focus on trying to sterilise our highly poisonous environment. It is now well known that immunity against physical illness is to a large extent compromised by societal pressures and lifestyle choices such as the lack of work-life balance, a mainly sedentary lifestyle, and the consumption of food additives and the mentioned antibiotics contained in many meat products.
Equally important, what should seem obvious, it is important to take a rest when we do not feel well rather than immediately using medication to keep functioning and to learn from one's minor illnesses to make the major ones redundant. In this sense, not addressing the environmental, lifestyle-related, and conflicts and feelings related (psychosomatic) causes of illness, both infectious and non-infectious should be seen as drivers of iatrogenic illness. Unnecessary treatments for profit should be viewed as unethical and contributing factors to illness caused by a medical system that has in many ways lost its original of first of all serve the health in the best possible ways.
In concluding this commentary, I wish to emphasise that not people are the problem but that the problem is the problem, with the problem being the currently dominant unsustainable and self-destructive paradigm. We have all been socialised into this paradigm, and the system often punishes those professionals who do not support it. At the same time, it is possible for many of us to step to a certain extent outside of the confinement of the current paradigm by enhancing our ability to lead sustainable lives. The more of us choose to reuse, repair, recycle, and reconsider the perceived fundamentals of their lives, the more we will be able to lead more sustainable lives and by doing so contribute to the urgently needed cultural and paradigm change. Not all is lost when antibiotics cease to work as the most important 'antibiotic' is our consciousness and willingness to create some long overdue changes.