The development of new antibiotics cannot be left to the market and Big Pharma alone, Pt II: Jan's happy return!

Update 5 July 2016:

Yesterday evening I revisited my friend Jan again, for the second time after I wrote my article about antibiotics on Monday last week (i.e. June 27th, 2016).

During the first week of his illness Jan had litterally clung on to life by the skin of his teeth, as he was very, very ill indeed. When I saw him that Monday, I was both sad and shocked and actually quite pessimistic about his situation: he seemed to be in a deep coma still, even though his situation was allegedly better than before.

However, within two days after that Monday, his situation improved strongly and he slowly, but surely woke up. When I visited him last Friday, it seemed that his strong mind and will-power had already returned to him, even though he yet could not speak due to the oxygen tubes in his throat.

And yesterday-evening when I visited him again, he was able to speak to me as the tubes were removed.  He was begging for water and icecubes and was silently cursing the nurses and doctors, who would not give him more water in order to quench his thirst. In other words: the old Jan had almost returned. 

Jan was still very exhausted, his muscles were yet unwilling due to two weeks without real movement and his body was quite swollen, due to the excess liquids that he had collected in it. Nevertheless, he was as much alive as before his illness. 

Antibiotics, the miracle drug had striken again and had rescued him from a certain death, due to lethal blood poisoning by a very aggressive bacteria.

And I’m grateful: grateful that this miracle drug still worked for my friend. And also for the many, many people with life-threatening infections and wounds.

Nevertheless, the group of people that can’t be helped anymore will grow unstoppably, if pharmaceutical companies and especially national governments and supranational government bodies will not run the gauntlet and quickly develop radically new antibiotics within the next five to ten years. Then, the strongest medical weapon, that the human race had in history, will have lost most of its fire power.

So, urge your own government as well as your universities and scientific institutes to a. develop these indispensable and truly life-saving drugs and b. to be serious about usage and abuse of the current generation of antibiotics.

Think about Jan and about other future victims of seemingly innocent infections, who could easily die when this miracle drug has lost its healing power.

Within one week the Brexit has turned the EU into a hostage of the United Kingdom: “It is for US to decide if and when we will we give you our Article 50 letter and leave the EU. Until then you all should wait and see!”

In The Netherlands we have this old joke:

A business man is approaching a group of activists, who are protesting at a large square. They are all screaming: “WE WANT WORK! WE WANT WORK! WE WANT WORK!!!”

The business man approaches one of the activists and says to him “Come with me to my factory, than I will give you a job”.

The activist looks at him in total astonishment and asks the business man: “ Why me?! There are so many others! “

I had to think about this old joke, when I heard the response of Michael Gove, with respect to the Article 50-letter in a snippet from the Financial Times:

Michael Gove has said Britain should not trigger Article 50, the legal mechanism for leaving the EU, until at least next year, putting the Conservative leadership hopeful at odds with European leaders.

Launching his campaign to become prime minister, the justice secretary argued that only someone who had campaigned for Brexit should lead the Conservative party; the frontrunner Theresa May campaigned on the Remain side.

His campaign launch comes after his dramatic decision yesterday to withdraw support for Boris Johnson, his long-time ally and the then favourite.

And so the British Conservative Party has put the European Union in the position where it wanted it: as the perfect unwilling victim, taken hostage by the Britons.

After the United Kingdom have blackmailed the EU for over three years (at least since 2013) with the upcoming-British-referendum-as-a-lever-for-political-change-in-favour-of-the-UK , the blackmailing campaign now continues with the unclarity about the exact moment that the UK will bring their Article 50-letter.

To make things worse: we are not even sure whether the Britons will indeed administer their dreaded letter, or will continue their challenged role as the handbrake on progress, preventing from necessary European change (i.e. both politically and economically), socialization, integration and democratization for eternity.

With the Article 50-letter hanging above the European Union as Damocles’ sword, the Tory government can in fact postpone the moment of administering until eternity. That is at least until the country receives the favourable terms for its Brexit that it wants, through shady ‘pre-negotiations’ and through the establishment of a series of dealbreakers and ‘red lines’.
The fact that the country and its representatives are now expelled from most European forums, like the European Commission (i.e. not de jure, but de facto), the European Parliament and the European Council is an inconvenient drag, but not really devastating for a favourable outcome of the Brexit process.

Before the UK will deliver the Article 50-letter, the country will be firmly at the helm of negotiations and future developments, as they are the ones with their hand on the Article-50 trigger. And so they created the perfect stalemate, which will either be exploited until the bitter end or until future elections in the United Kingdom bring a more pro-European government, formed by (for instance) a combination of the British Liberals and a “post-Jeremy Corbyn”, reformed Labour party.

As a matter of fact, it are not the Britons who are on the hook, but the European Union itself.

Is that fair?! No, it isn’t! But is it for real?! Oh yeah!

In hindsight, the real catch in the EU ‘exiting process’ is that the country, which wants to exit the European Union, is the same country that decides when the negotiations – and with that the two-year exiting period – will officially start: namely after the official administering of the Article 50-letter and not one second earlier.  

This strange catch in the European regulations gives the exiteer a considerable advantage upon those who stay behind, akin to the negotiations during a nasty divorce between a rich celebrity and his/her embittered spouse or husband. That is a situation that the smart Tories understand and exploit to the fullest.

And the longer and more painful this process runs for the EU, the bigger the chance is that also other populist-led countries within the EU see the success rate of this example and want to give it a shot for themselves.

What can the EU do?

The answer to this question was given by the savvy journalist and current resident of the United Kingdom, Joris Luyendijk, in a wonderful, but quite hostile article on Blendle. These are a few of his pruning hard statements:

As European citizens we have to seize the day and grab the opportunity to display a very critical stance against our politicians. We as citizens have to decide now which EU we really want, as of now. That would have never been possible with the Britons in it. They were never aiming at a better EU, but just at “as little EU as possible”.

The most important lesson that European politicians should learn from this fiasco, is that the EU not just have a communication problem. A large share of the lower and middle class Europeans feels like a cornered cat and look at the future with loads of uncertainty and doubt. The problem was that the EU itself was also an essential part of this globalization. When the EU now succeeds to establish itself as a protective cocoon against the aberrations of the globalization – for instance by setting and fixing the solidarity and social protection at a genuine European level – that would dramatically enhance the credibility of the EU among the European citizens.

[...]

Personally, I feel that it is in Europe’s interest to make the British elites bleed massively for their political hooliganism, so that they understand to the fullest what is their price to pay for their Brexit. The Britons did not only behave very badly against Europe, but the elites made a gargantuous blunder by letting Boris Johnson wheel and deal with the racists. Just because he wanted to become Prime Minister so badly. And please believe me: my heart breaks when I must act so toughly, as I really adore this culture in the UK. Yet, we cannot accept this terrible attitude much longer.

A few laser-targeted humiliations in order to let the hot air evaporize from the swollen British egos, could prove very efficient in the end.”

And you thought that I was angry?!

The ‘sorry’ moral of this very article is, however, that the United Kingdom is in the driver’s seat now. They don’t have any reason to speed  up the process and they are not even sure if they want to complete their Brexit at all. As long as the financial markets and the economy are not totally imploding within the United Kingdom, the clock ticks to the advantage of the Tories.

They can wait and force the EU to continue the coming years with ‘a broken down tyre’ (i.e. the UK), which hampers the necessary speed and progress to overcome this economic depression. That is the sad truth of the current Brexit conundrum.

And so the Brexit turned in yet another blackmailing attempt. 

Now, the remaining countries in the European Union must decide whether they stand tough or give in to those cunning, conservative Britons at Westminster after all. I am afraid that the latter will happen, to be fair!

The development of new antibiotics cannot be left to the market and Big Pharma alone, as effective antibiotics are a indispensable, even strategic asset for any country and supranational organization.

This article is dedicated to my friend Jan,

who is very much alive at this moment,

but could have been not anymore.

Jan and I are friends for already quite a long time. We met each other through our wifes, who went to the Dutch civic integration college together, and had a wonderful click since then. We found each other as worthy opponents in political discussions and discussions about a zillion other topics and as people who enjoy life to the fullest, On top of that we both got children at roughly the same time...

Jan and I think differently about a lot of fundamental things and his general position is more right-wing, while mine is more left-wing in the political spectrum. Nevertheless, we appreciate each others opinions and do agree upon a lot of topics, while differing on others. And Jan is a truly honest guy, in the best Dutch tradition of: ‘a man is a man and a promise is a promise’. His word is his guarantee and that is definitely an ironclad one.

Jan is also a person who helped me out in a few awkward situations, that all had to do with me driving or parking at places where I should not have driven or parked. One phone call and Jan was there to tow me loose. With a big, ironic, yet understanding smile on his face and a twinkle in his eyes, softly whispering: ‘You messed up, right?!’

But at this very moment, Jan is not smiling...

Jan lies in a coma in an academic hospital in The Netherlands, after he became critically ill. And even though his prognosis has fortunately improved during the last few days, he is still anticipating a long sickbed and a long, long period of revalidation, in order to be his old friendly, helpful and politically aware self.

Apparently, his illness started relatively harmless with a simple ear inflammation, but after a few days his left hand and arm became heavily infected with an extremely dangerous, flesh-eating bacteria: allegedly a streptococcus bacteria. Then his situation – which had been underestimated by the family doctor in the first place – deteriorated very dramatically and when he was finally brought to the hospital last Tuesday, he was in critical condition.

This morning I visited him in the hospital for a short period. It was heartbreaking to see this gentle giant of a man at the intensive care department, in quite a deep coma; hooked up to a respirator and all kinds of other machines that helped him to stay alive and survive his terrible illness. In the meantime, Jan is making small steps forward, but he is still in a very serious condition and will probably be the next few days.

When Jan survives his illness – I know he will – he will owe his life to extremely strong, broad spectrum antibiotics and to the fact that this miracle medicine is still able to kill even the most dangerous bacteria species present in The Netherlands.

However, that is not so obvious as it sounds anymore...

The global emergence of various kinds of multi-resistent bacteria inside and outside hospitals is an extremely worrisome development: think for instance about the emergence of such bacteria in the open waters, that will be used during the Olympic Games in Rio de Janeiro.  

The fact that doctors and hospitals in many countries still recklessly administer antibiotics to humans in situations when it is absolutely not necessary, or that people still don’t use this drug in accordance with the prescribed way, is very hazardous for the effectivity of these antibiotics: bacteria which receive a less than lethal portion of antibiotics, might grow resistant for it, thus changing in genuine killer bugs.

The fact that live cattle keepers/breeders and fish farms still use shedloads of preventive antibiotics, to protect their live stock against dangerous diseases in their overcrowded stables and fish farms, is even more dangerous.

Five years ago I wrote an article about the need to develop new antibiotics, in order to fight the emergence of multi-resistant bacteria, which cannot be destroyed at all by any of the current kinds of antibiotics; even in combinations. Since that article, it seemed to me that the silence from the pharmaceutical industry has been deafening...

In the meantime Big Pharma kept producing new cardialgia inhibitors, anti-cholesterol drugs, antidepressants, blood thinners, anti-diabetes drugs and other drugs that are there in order to cure, but often especially to contain (!) Western lifestyle diseases. Drugs that – as a matter of fact – I also need on a daily basis to keep my current quality of life; at least some of them: I have to admit that.

Such ‘lifestyle disease containment drugs’ are money makers for the pharmaceutical industry, as the patients in many cases have to use them for a long, long time and quite often even for life. Those pills are like a checkbook that automatically writes a big paycheck every month, for every company that produces them.

Unfortunately, new antibiotics are notoriously hard and extremely expensive to develop, while taking years and years to do so. On top of that they are probably not the real money-makers that these other lifestyle pharmaceuticals are.

The obvious result of this is that the development of new antibiotics still suffers from the stepmotherly treatment that these indispensable, life-saving pharmaceuticals get from the industry.

But the world cannot wait anymore...

In case of large scale local (or global) wars with loads of critically wounded people or large, uncontrollable outbreaks of bacterial diseases, the presence of effective antibiotics can be a matter of life and death for millions and millions of people. And the current types of antibiotics seem to lose their effectiveness at an alarming speed.

This is the reason that international governments and supranational, governmental organizations, like the EU, should run the gauntlett and actively start to push the development of new antibiotics.

Not in ten years, not in five years, but now!

The development of new and effective antibiotics is just too strategically important to leave it to the quirks of the free, international pharmacy markets. Yes, strategically important is the right expression!

This development of antibiotics is so important that governments should invest billions of dollars in it. Not in the form of warrant-free subsidies on behalf of the common pharmacy companies, but directly: in strategic, government-owned research centres, hospitals and laboratories, with the help from the best universities and the brighest scientists.

After development, these new antibiotics should not be used for widespread medication against relatively innocent human diseases, or on behalf of the cattle and fish-farming industry.

No, they should be maintained as anti-bacterial weapons of last resort, in case that all other medicine fails. It is our duty and the duty of our governments to do so and not to wait until it is too late.

Jan’s wife, his children and his next-of-kin, as well as my wife and I, all hope that Jan will open his eyes very soon and soon afterwards is able to pick up his former life again. He will probably be saved by the current generations of antibiotics.

But we must see to it that this privilege is also reserved for our children and grandchildren and their friends, in the remainder of this Century. This is a privilege that we should not abandon lightheartedly.

Think about Jan or about your own children and grandchildren and urge your favorite politicians to come into action! It might save millions of lives!