被忽视的危机——超级菌

如果要问人类现在面临的最大的健康问题是什么，或许你听到的答案绝大部分都是癌症、艾滋病或是心血管疾病等。但是，很少有人注意到一个危机已经悄悄地来到我们身边，成为我们的心腹大患--超级菌。

事实上，这一危机的影响已经不仅仅局限在健康领域，甚至已经波及到全球经济稳定。今年，英国首相卡梅伦委托著名经济学家Jim O'Neill调查超级菌对世界各国各方面的影响，结果令人大吃一惊。

根据统计，目前全球每年因为抗药性微生物感染死亡的人数为七十万人，如果不再采取有效措施的话，这一数字到2050年将超过一千万人，甚至超过癌症的死亡人数。仅在欧洲和美国，每年就有约五万人死于超级菌，到2050年，这一数字将变成现在的十倍！此外，由此而产生的花费将达到惊人的63万亿英镑，占到了全球经济总量的2%-3.5%。而英国的GDP目前也仅为3万亿英镑。

Jim O'Neill介绍说这些经济损失中包含了医药费用的支出以及患者因感染而导致的各种误工等情况。他甚至认为，这一问题在短期内给人类带来的威胁甚至超过了全球气候变化问题。目前，抗药性大肠杆菌、疟疾病原体和结核杆菌时对人类威胁最大的三类病原体。

Jim O'Neill是著名的经济学家，尤其是以其对发展中国家的研究而闻名。他提出的金砖四国（巴西、俄罗斯、印度和中国）以及薄荷四国（墨西哥、印度尼西亚、尼日利亚和土耳其）等概念也已经广泛被接受。因此，在这项研究中他还特意指出，超级菌的威胁对于发展中国家尤为严重。以尼日利亚为例，到2050年，预计约有四分之一的死亡是由超级菌感染导致的。

同时，Jim O'Neill在研究中还列举了现阶段我们能够采取哪些措施：

1 如何用药能有效降低抗药菌的出现

2 如何促进新型抗生素的研发

3 如何促进国际间关于应对抗生素滥用和超级菌的合作

事实上，细菌抗药性也已经引起了生物产业界的广泛关注。自从上世纪初青霉素问世以来，感染问题已经从过去威胁患者死亡的重大问题变为了一种常见小病。然而，由于最初对抗药性的认识并不深入，抗生素滥用问题一直未能得到有效重视。而抗生素的研究利润过低，又使各个生物医药公司对这一领域不闻不问。最终造成了抗药菌越来越难以控制的局面。就在最近几年，早已退出抗生素研究领域的各个生物医药巨头如辉瑞等纷纷宣布重回这一领域也足以说明这一问题的严重性。

详细英文报道：

Drug resistant infections will kill an extra 10 million people a year worldwide - more than currently die from cancer - by 2050 unless action is taken, a study says.

They are currently implicated in 700,000 deaths each year.

The analysis, presented by the economist Jim O'Neill, said the costs would spiral to $100tn (?63tn).

He was appointed by Prime Minister David Cameron in July to head a review of antimicrobial resistance.

Mr O'Neill told the BBC: "To put that in context, the annual GDP [gross domestic product] of the UK is about $3tn, so this would be the equivalent of around 35 years without the UK contribution to the global economy."

The reduction in population and the impact on ill-health would reduce world economic output by between 2% and 3.5%.

The analysis was based on scenarios modelled by researchers Rand Europe and auditors KPMG.

They found that drug resistant E. coli, malaria and tuberculosis (TB) would have the biggest impact.

In Europe and the United States, antimicrobial resistance causes at least 50,000 deaths each year, they said. And left unchecked, deaths would rise more than 10-fold by 2050.

Graph

Mr O'Neill is best known for his economic analysis of developing nations and their growing importance in global trade.

He coined the acronyms Bric (Brazil, Russia, India and China) and more recently Mint (Mexico, Indonesia, Nigeria and Turkey).

He said the impact of the would be mostly keenly felt in these countries.

"In Nigeria, by 2050, more than one in four deaths would be attributable to drug resistant infections, while India would see an additional two million lives lost every year."

Global map of deaths

The review team believes its analysis represents a significant underestimate of the potential impact of failing to tackle drug resistance, as it did not include the effects on healthcare of a world in which antibiotics no longer worked.

Joint replacements, Caesarean sections, chemotherapy and transplant surgery are among many treatments that depend on antibiotics being available to prevent infections.

The review team estimates that Caesarean sections currently contribute 2% to world GDP, joint replacements 0.65%, cancer drugs 0.75% and organ transplants 0.1%.

This is based on the number of lives saved, and ill-health prevented in people of working age.

Without effective antibiotics, these procedures would become much riskier and in many cases impossible.

The review team concludes that this would cost a further $100tn by 2050.

Mr O'Neill said his team would now be exploring what action could be taken to avert this looming crisis.

This would include looking at:

o how drug use could be changed to reduce the rise of resistance

o how to boost the development of new drugs

o the need for coherent international action concerning drug use in humans and animals

Mr O'Neill said the support of the Bric and Mint nations was vital.

He noted that China would be hosting the G20 summit in 2016 and said he hoped this issue would be a focus of discussion.

'Compelling'

He said scientists seemed more certain that drug resistance would be a major problem in the short term, than they were over climate change.

Dr Jeremy Farrar, the director the Wellcome Trust, said: "By highlighting the vast financial and human costs that unchecked drug resistance will have, this important research underlines that this is not just a medical problem, but an economic and social one too."

Prof Dame Sally Davies, chief medical officer for England, said: "This is a compelling piece of work, which takes us a step forward in understanding the true gravity of the threat."

The review team concludes that solving the problem of drug resistance will be far cheaper than doing nothing and there was "cause for optimism" that the right steps could be taken.

This included university researchers and biotech entrepreneurs "teeming with ideas" including new drugs, vaccines and alternative therapies such as antibodies.

Investment

Laura Piddock, professor of microbiology at the University of Birmingham, is focusing her research on bacteria such as E. coli and salmonella, which are responsible for a growing level of drug resistant infections.

Both are so-called gram-negative bacteria, which have a complex cell wall that acts as a barrier to drugs. If they do penetrate the wall, they are "vacuumed out" by the cell.

She said: "My team is looking at what are the switches in those bacteria which turn that vacuum cleaner off, and at molecules which would have the same effect. If we can do that, we can make the bacteria sensitive to antibiotics."

Prof Piddock said there had not been enough global investment in finding new drugs.

She said: "It is very difficult to find drugs against bacteria like E.coli because they are so naturally resistant.

"We need more investment and new business models to ensure the pipeline is filled with promising molecules, to ensure that we can solve this problem, and make sure the drugs are there when patients need them."